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Letter from the Editor
ou’ll notice a theme emerging in this issue of Pf Magazine. ‘Healthcare in wider society’. Not so long ago, our only connection with the state of our own bodies began in the GP surgery and ended as we closed the door on the way out. Two major shifts have occurred, which have driven healthcare into the open – digital and self care. Consequently, healthcare as we know it is changing, rapidly. There is no better example of this than instant testing, as our cover story strikingly underlines. Administering your own HIV test, or receiving a diabetes test through the post, would have been unimaginable a few years ago, but now patients are changing the old order. In a remarkable Coffee Break, I chat with a trans woman who has lived with HIV for 25 years, but has become symbolic of the freedom to be who you want to be, regardless of stigma. Continuing the subject, our disease area focus explores sexually transmitted infections and how the attitude to them has changed since the advent of widespread awareness-raising campaigns. Talking of awkwardness, men have consistently struggled to reconcile masculinity with their own health for years. In this issue, we find out whether all the effort to direct the male species into an unfamiliar, health-conscious space is really working. We’ve also got the usual heady cocktail of insight and intrigue from our regular columnists; Deborah in the aisles of pharmacy, David in the NHS maze and Alex in the corridors of power. Meanwhile, another masterclass in marketing, a lingering look at pharma’s social responsibilities and a plethora of regulars complete an enticing roster. Great talking to you,
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Bringing you this month’s essential headlines C OV E R S TO RY
Is instant testing technology really the future? OPINION
Deborah Evans on truly valuing medicines POLITICS
Alex Ledger navigates Britain’s access to meds COFFEE BREAK
Trans pioneer Juno’s jouney to freedom MARKETING
How to maximise return on investment OPINION
David Thorne on the importance of patient data
September READER’S VOICE: I very much enjoyed last month’s theme of mental health. Successful campaigns in recent years have greatly improved public awareness of this area so, naturally, we can expect better diagnosis and treatment. Mental health services, however, are still notoriously underfunded and threatened by cuts from austerity measures. Investing further is essential, not only for patients, but for the efficiency and sustainability of the health service itself, given the host of comorbidities seen in conditions such as depression. It’s clear there is still some way to go to achieve parity with physical conditions, but we can take inspiration from the shift in attitudes towards cancer and the dissipation of its stigma. As we advance further into the digital age, the flow of available information into the public domain has never been
greater, and our ideas and perceptions have never been so easily challenged. Pharma has both an opportunity and a responsibility to engage with the public on these issues and further drive awareness. Having the information and confidence to promote discussions with healthcare practitioners will help patients seek treatment and find the therapies that are best for them. Furthermore, better informed patients have the potential to be hugely valuable. This may, however, be threatened by unhelpful online ‘noise’. With such a wealth of online information available, accurate or otherwise, pharma will be faced with a vital role in keeping inappropriate or mistaken information at bay, while making valuable and ethical content available for patients that need it. Emma Phillips, Account Executive, Reynolds-MacKenzie.
F E AT U R E
Link between height and prostate cancer examined F E AT U R E
Pharma’s social responsibility in sharp focus F E AT U R E
Are men getting better at monitoring their health?
HAVE YOUR SAY: What is the impact of NICE’s approvals process? Are counterfeit pharmaceuticals a problem in Britain? Has the crusade against breast cancer been a success story? We’ll be covering these issues in the next Pf Magazine – want to contribute? GET IN TOUCH: email@example.com @pharmafield
F E AT U R E
Expert analysis of sexual health in Britain today P H A R M ATA L E N T
An inspirational Learning & Development masterclass P H A R M ATA L E N T
Haseeb Ahmad shares the secret of his success O N YO U R R A DA R
BE IN THE KNOW. To request a FREE print subscription for your workplace, or to sign up to our weekly newsletters for the essential headlines, Jobs of the Week, Pharmatalent and thought-provoking features, visit pharmafield.co.uk/subscribe This issue and all past issues of Pf Magazine can be viewed online at issuu.com/pfmagazine
A glance across the wider healthcare landscape
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A N T I M I C R O B I A L R E S I S TA N C E .
Doctors must stop advising people to finish prescribed courses of antibiotics because it is increasing the threat of antimicrobial resistance, health experts have warned. Specialists from bodies including the University of Oxford and Public Health England now say that to avoid overuse of antibiotics, patients should be advised to only take them until they feel better.
This new advice is in contradiction to current guidance from the NHS and World Health Organisation which say it is essential to ‘finish a course’ of antibiotics. The theory behind the guidance was that failing to take enough tablets would allow bacteria to mutate and become resistant. An article from 10 experts in the BMJ, however, said that the health message is not backed by evidence and should be dropped. Lead author Martin Llewelyn, Professor of Infectious Diseases at Brighton and Sussex Medical School, said: “The idea that stopping antibiotic treatment early encourages antibiotic resistance is not supported by evidence, while taking antibiotics for longer than necessary increases the risk of resistance.” Chief Medical Officer Dame Sally Davies responded by saying: “The Department of Health will continue to review the evidence on prescribing and drug resistant infections.” Pf View: For years patients have suspected that endlessly taking antibiotics when they felt fine was odd, but obeyed the doctor anyway. Now it seems we were right all along, but at what cost?
ngland’s Chief Nursing Officer has launched a 10-point action plan to recognise and develop the roles of general practice nurses. ‘Developing confidence, capability and capacity – the ten-point action plan for General Practice Nursing’ brings together key actions which aim to meet general practice workforce challenges by attracting new recruits, supporting existing nurses and encouraging a return to practice. An increasing and ageing population with multiple complex
health conditions has led to increased pressure on the workforce. The plan, therefore, is backed by £15 million and sets out key milestones which will allow progress to be measured across General Practice Nursing for the first time. Professor Jane Cummings, Chief Nursing Officer for England, said: “I am determined to ensure a proper career development programme for those who choose this vital path and make it an attractive first choice for newly-qualified nurses.”
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PA R T N E R S H I P S . DEMENTIA
MAKES SENSE Research results reported at the Alzheimer’s Association International Conference 2017 have provided clues about associations between cognitive status in older people and several behaviour and lifestyle factors, including verbal skill. Researchers at Wisconsin Alzheimer’s Institute, University of Wisconsin School of Medicine and Public Health, studied whether people with very early memory declines also showed changes in their everyday speech. It was found that subtle changes, such as the use of short sentences, more pronouns, and pauses like “um” and “ah,” correlated with early Mild Cognitive Impairment (eMCI), which can be a precursor to Alzheimer’s disease. In the study, researchers analysed two speech samples, taken two years apart, from 264 participants. Of these participants, 64 were identified as having eMCI based on cognitive testing over eight to 10 years. The speech samples were collected by asking the participants to describe a simple picture. Dr James Pickett, Head of Research at Alzheimer’s Society, said: “In future innovative tests like this could help to detect the early signs of dementia, which could lead to a more accurate and timely diagnosis.”
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LAND OF THE GIANTS
straZeneca and MSD (Merck) have announced the establishment of a global strategic oncology collaboration to codevelop and co-commercialise AstraZeneca’s Lynparza (olaparib) for multiple cancer types. The companies will develop and commercialise Lynparza jointly, both as a monotherapy and in combination with other potential medicines. Independently, the companies will develop and commercialise Lynparza in combination with their respective PD-L1 and PD-1 medicines, Imfinzi (durvalumab) and Keytruda (pembrolizumab). Lynparza is an innovative, first-in-class oral poly ADP ribose polymerase (PARP) inhibitor currently approved for BRCA-mutated ovarian cancer in multiple lines of treatment. 14 indications are currently being developed across several tumour types, including breast, prostate and pancreatic cancers.
A P P R OVA L S
Subs bench Boehringer Ingelheim has commenced VOLTAIRE-X, an interchangeability study that aims to demonstrate that BI 695501 is interchangeable with AbbVie’s Humira, the branded drug upon which the biosimilar is based. 240 patients with moderate to severe chronic plaque psoriasis will be enrolled on the study, which will assess safety, immunogenicity and efficacy. Pharmacokinetics and clinical outcomes will also be compared between patients receiving Humira continuously and those who switch repeatedly between Humira and BI 695501. The findings of the trial are set to support regulatory applications for the therapy and results from the study are expected in the second half of 2019.
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lmost 40% of carers who reported the most serious financial difficulties also felt socially isolated, according to a survey of carers from NHS Digital. The Personal Social Services Survey of Adult Carers in England 2016-17 reports on the views of 55,700 carers who are caring for a person aged 18 or over. For carers who reported not having financial problems caused by their caring duties (54%), almost 10% felt socially isolated. Financial difficulties caused by caring responsibilities was the only variable found to have a statistically significant effect on every question analysed in the report. The report revealed that 21% of carers surveyed have been providing unpaid care for over 20 years, while 71% were extremely, very or quite satisfied with the support or services they received, compared to 13% who were extremely, very or quite dissatisfied. Also, 90% of carers aged 85 and over (22,100) have caring responsibility for someone aged 75 or over. The average quality of life score for carers in England is 77 out of 124; carers who had a quality of life score lower than the national average are more likely to spend 50 hours a week or more on their caring responsibilities.
Survival plan According to new analysis, people with the six less survivable cancers in England are nearly five times less likely to survive beyond five years, compared with patients with one of the 11 more survivable cancers. Those with more survivable cancers have, on average, a 64% chance of living beyond five years, whereas people with less survivable cancers – pancreatic, liver, brain, lung, oesophageal and stomach – only have a 14% chance. The disparity has been revealed by the Less Survivable Cancers Taskforce; five charities which have joined forces with the aim of transforming the future of people with the lower survival rate cancers. The Taskforce is made up of Pancreatic Cancer UK, the British Liver Trust, The Brain Tumour Charity, Action Against Heartburn and Core. It says that the unacceptable prognosis of the six cancers is due to a number of factors, including a lack of research. The analysis also shows that these cancers cause over half (51%) of all deaths from common cancers in the UK per year – close to 70,000 deaths. Over the last 12 years, the six diseases received 17% of UK research funding for common cancers, with the remainder dedicated to the 11 more survivable cancers. John Baron, MP for Basildon and Billericay and Chair of the All-Party Parliamentary Group on Cancer, said: “We need to ensure that less survivable cancers receive attention, particularly when it comes to improving research, diagnosis and treatment.” Pf View: As discovered in recent issues of Pf Magazine, less survivable cancers impact hugely on individuals, families and society. It is great to see that influential organisations are attempting to address the disparity among cancers.
Quick doses NICE recommends TE VA’s CINQAERO® (reslizumab) for the treatment of adult patients with severe eosinophilic asthma. • B R I S TO L- M Y E R S S Q U I B B and C LOV I S O N CO LO GY enter clinical collaboration agreement to evaluate combination of B-MS’s Opdivo and Clovis’s Rubraca.
S A N O F I and specialty care global business unit Sanofi Genzyme receive CHMP positive opinion for Dupixent® (dupilumab). • E I S A I submits marketing authorisation application to the EMA for the first-line use of lenvatinib in patients with unresectable hepatocellular carcinoma.
British biotech business TO P I V E R T initiates clinical trials with two of its narrow spectrum kinase inhibitor drug candidates. • A S TR A Z E N E C A and M E D I M M U N E ’s partner L E O P H A R M A granted full EU marketing authorisation for Kyntheum (brodalumab)
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S TAT I N S
he Committee for Medicinal Products for Human Use (CHMP) of the European Medicines Agency (EMA) has issued a positive opinion recommending marketing authorisation for Janssen’s Symtuza™, a once-daily darunavir-based single tablet regimen. If approved, it will be the only therapy of its kind indicated for the treatment of human immunodeficiency virus type 1 (HIV-1) infection in adults and adolescents aged 12 years and older with body weight of at least 40 kg. A Phase III clinical trial programme investigating the efficacy and safety of the darunavir-based combination is also underway. Lawrence M. Blatt, Ph.D., Global Therapeutic Area Head, Janssen Infectious Diseases Therapeutics, said: “We are extremely excited to be one step closer to getting this therapy to people living with HIV and in doing so reducing the treatment burden faced by many.”
The UK is trailing behind the rest of Europe in the diagnosis and treatment of cancer, according to a report commissioned by the ABPI. British patients were found to have worse survival rates after five years, compared to the European average, in nine out of 10 cancers. The analysis was launched alongside an online toolkit, which allows the data to be used to easily compare UK and EU cancer care. The report revealed that UK cancer survival rates lag behind the European average in 9 out of 10 cancers and, if the UK achieved the cancer survival rates of Germany, over 35,000 more people would be alive five years after diagnosis. It also stated that the UK has the second worst survival rates for lung cancer, with only 8% of patients surviving more than five years, ahead only of Bulgaria at 7%. The UK also has
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Enemy of the statin Healthcare professionals should offer statins to millions of people with chronic kidney disease (CKD) to help to manage their increased risk of cardiovascular disease, according to NICE. The new NICE standard lists Atorvastatin as the preferred statin to offer patients because it is both clinically and cost effective. CKD is a long-term condition associated with ageing where the kidneys no longer work as well. Around 2.6 million people in England have CKD and approximately 60,000 people die prematurely each year because of it. Professor Gillian Leng, Deputy Chief Executive at NICE, said: “The effectiveness of statins is now well proven, as is their long-term safety.”
the second worst survival rates for pancreatic cancer, with 3% of patients surviving more than five years, ahead only of Iceland at 2.56%. Meanwhile, if the UK had the mortality rates of France, more than 100,000 women’s deaths could be prevented over the next 10 years. On patient access to medicines, the report also found access to cancer medicines is consistently lower than most European countries. Dr Richard Torbett, Executive Director at the ABPI, said: “This should be a wake-up call for the UK to refocus the way we tackle cancer across the board.” Pf View: This should be a very worrying set of revelations for the NHS, pharma and wider healthcare. It is perhaps symptomatic of our health services and providers thinking they are doing better with cancer than they actually are.
N E WS FO CUS Looking at a notable story in sharp focus
Former pharma chief wins new commercial role at DH
What does Steve Oldfield’s appointment mean for pharma?
urrent Chief Operating Officer for PGT, Steve Oldfield, will take up the newly-created role of Chief Commercial Officer at the Department of Health (DH) this October. He will be one of the new cohort of senior commercial managers tasked with improving the performance of the NHS’s supply chain. His initial focus will be the creation of a commercial strategy which will underpin upcoming negotiations with a variety of commercial suppliers. This includes key engagements with the pharmaceutical industry. Oldfield has over 25 years of experience in the healthcare industry, as UK Managing Director for both Sanofi and Teva. He has also been involved with industrygovernment initiatives, having served on the Board of the ABPI and co-chaired committees looking at the introduction and adoption of new medicines. Chris Wormald, Permanent Secretary, Department of Health, said: “We see huge opportunities for better delivery for patients and better value for money for the taxpayers from improved commercial skills and experience.”
E X P E R T A N A LYS I S
P f N E WS : B R IN G IN G YOU TH I S M O NTH ' S E SS ENTI A L H E A D LIN E S
PAU L M I D G L E Y Director of NHS Insight, Wilmington Healthcare
The DH will benefit greatly from Steve Oldfield’s insights and his colleagues will gain a deeper understanding of pharma’s business model and its protracted, risky and hugely costly drug development lifecycle. Steve will be well aware of the frustrations of many ABPI member companies with the current scheme, and that of the wider NHS. Currently the Pharmaceutical Price Regulation Scheme (PPRS) cap and rebate provides no benefit to the local NHS and is absorbed at DH level. This has stifled local health economies’ ability to reinvest savings on branded medicines into investing in new technology, including NICE approved medicines. The current PPRS scheme has also been detrimental for many companies’ UK affiliates profits and, post Brexit, Steve will be very mindful of the additional pressures on global pharma to disinvest in the UK. How he handles the next PPRS settlement will support the Government’s position that UK pharma is open for business.
L E S L I E G A L LOWAY EMIG Chairman
Let us be quite clear, Steve’s new role will be to secure the best deal for Government in the new round of negotiations. What does the current environment for pharmaceuticals hold in store in these negotiations? The factors that will impact are: • Growth in the economy is slowing and the FT reports that UK consumer confidence has fallen to post-Brexit poll levels. Economists are forecasting that people will cut back as price rises outpace wage growth. Remember, the economy funds the NHS. • Simon Stevens has focused on the significant growth (7%) of his NHS medicines bill in the Five Year Forward View Next Steps and his intended actions to address it – so the PPRS has not been working for the NHS. • Possibly the biggest issue of all is the Health Service Medical Supplies (Costs) Bill which the Government will shortly consult on. The Bill will make the PPRS quite a challenge to negotiate.
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New innovations in testing Self-testing is now available for a number of health conditions, but what does instant diagnosis mean for patients and the healthcare system?
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Amy Schofield |
I L L U S T R AT I O N B Y
ince the first home pregnancy test in the 1960s, self-testing kits for diseases and conditions such as human papilloma virus (HPV), diabetes and high cholesterol have emerged online or in pharmacies. Meanwhile, in many areas of the UK, home-testing kits for chlamydia, gonorrhoea and others have become available as free locally-commissioned healthcare services. Self-diagnosis goes beyond a vague internet search; it is becoming the norm. Pharma will be keeping its own finger on the pulse as increased diagnosis leads to greater demand for products.
E AR LY DAYS Dr Clare Morrison, GP at online doctor and pharmacy MedExpress says: “These tests will probably cause more pressure on primary care, as patients will want to ask about abnormal results with an expert, but they aren’t necessarily a bad thing for patients. If a patient knows that they are positive for HPV, for example, they can make sure they get regular cervical smears to pick up abnormalities.” Although self–testing can be of benefit, there can be other factors at play that may affect test results. “Glucose testing isn’t a bad idea if you have reason to suspect diabetes, perhaps because of excessive thirst or a strong family history, but bear in mind the fact that it will be affected by anything you have eaten recently,” cautions Dr Morrison. “Just because you test negative, it doesn’t necessarily mean that you are entirely safe. High cholesterol and diabetes are more common as you age and gain weight, so testing when you’re young and slim may not detect it,” adds Dr Morrison. Go to medexpress.co.uk
“Testing puts you in control”
D OWN S I D E S Superdrug pharmacist Tim Morgan urges patients to follow up: “In crude terms, some tests are more accurate than others and most home tests do not boast 100% accuracy. Although home-testing kits increase accessibility, if there is no process behind the test that allows the patient to receive advice around, for example, safe sex and STI prevention, then the test itself is not encouraging behaviour change.” Self-testing kits for conditions such as diabetes are readily available online, however, charity Diabetes UK does not recommend their use to diagnose the condition. Douglas Twenefour, Deputy Head of Care for Diabetes UK, advises: “We would not recommend people to use a self-diagnosing kit if they are worried they have diabetes. Self-diagnosis results might not be accurate, as blood glucose levels vary in all individuals during any given day and people might be falsely reassured,” he explains. “In addition, a positive diagnosis can only increase anxiety if someone does not have access to information and advice provided by a trained healthcare professional.”
“Self-diagnosis goes beyond a vague internet search, it is becoming the norm.”
TAK I N G CO NTRO L The Terrence Higgins Trust (THT) is in favour of HIV self-testing, Dr Michael Brady, THT Medical Director, says: “One in seven people living with HIV do not know they have it. Testing puts you in control and, thanks to treatment, will stop you from getting seriously ill, enable you to live a normal lifespan and prevent you from passing the virus on to anyone else,” he explains. “It’s so important that we continue looking for new ways to make HIV testing more accessible.” The Trust launched a self-testing pilot in July 2016, then a further scheme in May 2017. The pilot offered people the chance to find out their HIV status privately, by taking an HIV self-test and getting their results in just 15 minutes. The scheme targeted men who have sex with men and black African people in the UK – the two groups most affected by HIV – and was promoted through targeted social media, including Grindr. “Our pilot scheme was a real success in terms of developing our plans for increasing HIV testing in the future, but was also important for the people who took it who may not otherwise have known their status,” Dr Brady says. “Self-testing, alongside other HIV testing strategies, gives us the opportunity to test for HIV at the scale needed to really impact on the epidemic.” Dr Brady advises that although tests are highly accurate, with a clinical sensitivity of 99.7%, patients should always follow up HIV self-diagnosis with a healthcare professional. “We advise anyone who does receive a reactive [positive] result to contact a local sexual health clinic for confirmatory testing and encourage them to call our helpline.” Go to tht.org.uk or call THT Direct on 0808 802 1221
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“My first thought was that it must be wrong. I wanted to pretend it had never happened”
first found out about the THT selftesting pilot for HIV in 2016, when I noticed a pop-up post on Grindr. It was free and offered a result within 15 minutes. The last thing on my mind was that it would come back positive. I’d had a full STI and sexual health check in 2015 and it was all clear, and I didn’t think I’d done anything in the meantime to contract HIV. The test looked so simple. It just involved pricking my finger and blood being sucked up into a little valve. Two lines meant a positive result. When the lines appeared, I was shocked and devastated. My first thought was that it must be wrong. I wanted to put it in the bin and pretend it had never happened. I was on my own and was terrified. The advice with the test said that if the result was positive, you need to go to your local sexual health clinic for confirmation. I didn’t have a clue where to go and felt completely lost. I tried going to the local sexual health clinic, but I couldn’t get an appointment with them for two or three days. Then I showed my doctor the test. I still had my hopes up that the result was a mistake. He sent me to a sexual health clinic, where I had a full STI check. Two days later the test came back positive. Once diagnosed, I thought that was it for me. My main fear was that I would transmit the virus to someone else, like my partner. When I told my family, they gave me 100% support. I now take one tablet of Genvoya a day, which can control the virus. Having the option of self-testing gives people the opportunity to get the test as easily as a pregnancy test. Since taking it myself, loads of my friends have taken it, gay and straight, male and female. I would advise anyone who wants to know, to do a self-test.”
M I C HAE L N U G E NT
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TE S T O F TI M E While pressure on primary care services continues to pile up, more people may turn to self-testing. “As technology continues to rapidly advance, it is inevitable that the use of home or portable testing will become readily available. There are already products being developed that allow for blood testing through smartphones and this could prove the most convenient way for people to get quick and accurate tests without having to access the GP,” says Tim Morgan. Dr Morrison urges people to seek advice from a healthcare professional, whatever the outcome of a home test. “For something straightforward, a pharmacist is the best starting point. If necessary they will advise you to see a doctor anyway,” she counsels. “If my patients have a health worry I would urge them to see an expert. We are here to help, not make judgements, and everything is entirely confidential.”
APP I N HAN D Monitoring tech for generation self care
1. Instant Heart Rate + 2. Dario diabetes app 3. Kardia heart app 4. Blood Pressure (SmartBP) 5. Specsavers Hearing Check App
Cabinet reshuffle Community pharmacists are providing invaluable support to patients on new medicines
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“New Medicine Service support can make the difference between continuing treatment or not” WORDS BY
id you know that since October 2011, 90% of community pharmacists in England have provided support to people with long-term conditions who have been newly-prescribed a medicine? Indeed, since the beginning of service, until March 2017, over 4 million complete New Medicine Service (NMS) interventions had been provided to patients within community pharmacies. This NHS England commissioned service is designed to help improve medicines adherence at a time when people are most likely to stop, and is currently focussed on specific patient groups and conditions. Following the roll-out in 2014, the Government commissioned a study into NMS effectiveness. The report by Nottingham University recommended that, as the NMS delivered better patient outcomes at a reduced cost to the NHS, it should continue. This is further supported by a recently published economic evaluation, which concludes that it improves patient’s adherence, translating to increased health gain at reduced cost.
WHAT IS THE NEW MEDICINE SERVICE? The NMS provides early patient support to maximise the benefits of their newly prescribed medicine and involves three stages: 1. Engagement, where the patient is recruited into the service 2. I ntervention 7-14 days later 3. Follow-up 14-21 days later
S U P P O RT SYS TE M During both the intervention and follow-up stages, the pharmacist will discuss with the patient how they are getting on with their new medicine. This involves assessing their adherence, identifying any problems, and providing information and support in person or over the phone. I’ve provided several NMS interventions for patients who have been newly diagnosed with a long-term condition, such as diabetes, or had a progression in their condition which required new medicine. These patients are often vulnerable and overwhelmed by information provided from their GP or hospital doctor, and welcome having a more detailed discussion. We can also explore side effects or any beliefs that might affect how they take their medicine. One woman, prescribed metformin for type 2 diabetes, was grateful to have my support for weight management, while a man prescribed an antihypertensive was reassured that his transient hypotension would pass, and starting his treatment in the evening really helped. This support can make the difference between continuing treatment or not. The challenge is to integrate this service into patient care pathways and enable more community pharmacists and other healthcare professionals to understand the benefits. Six years on from the implementation of NMS, we believe it is time to extend this service to other patient groups, such as those with mental health conditions, where adherence is poor. What could the role of industry be to support this excellent service? We have over 11,000 experts in medicines in the community currently providing an evidence-based patient support programme. I’ll leave you to consider how you could participate. Thank you to Michael Holden, Principle Associate, Pharmacy Complete for his contribution to this piece. Deborah Evans is Managing Director of Pharmacy Complete, a specialist consultancy and training company enabling a healthier future for pharmacy. Go to pharmacycomplete.org
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if you can get it Access to medicine is at a critical crossroads.
I WORDS BY
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s speed of access to new medicines for patients getting better? According to NICE it is. The world-renowned drug assessor has even published a feature with the snappy title: Patients getting faster access to cancer drugs as NICE approves three quarters of the Cancer Drugs Fund. The news came as NICE announced that it was approving sorafenib, a treatment for progressive liver cancer. Its positive appraisal marks the 18th of 24 drugs NICE was asked by NHS England to appraise, as part of the new Cancer Drugs Fund (CDF). All have been approved for routine NHS use. In order to achieve these decisions, however, manufacturers have been required to provide price discounts and, in some cases, additional data. Some have been required to enter into ‘Managed Entry Agreements’ with the NHS whereby their approval is contingent on the satisfaction of further, real-world evidence, that will be re-considered at a later point in time to evaluate longer-term patient access, and an acceptable price. It remains to be seen how these future negotiations will operate and whether shortterm, wider patient access will be restricted or even reversed. This would prove controversial and highly disappointing to patients.
This news might not be giving us the full picture, however. The ABPI released a report in July, produced by the Institute for Health Economics, based in Sweden, which suggested that the UK is trailing behind the rest of Europe in the treatment of cancer. The submission added that the NHS spends over 20% less of its overall healthcare budget on cancer than the rest of the EU. According to the study, British patients have worse survival rates after five years, compared to the European average in nine out of 10 cancers, only exceeding the EU average in melanoma. The functionality of the new CDF, operating under NICE, might well help to correct this course over time and, it’s true, cancer outcomes depend not just on new generations of treatments, but overall service investment and quality. There are also challenges to the speed by which patients are accessing new medicines outside oncology. The UK’s Office for Health Economics also published a new review earlier this year comparing access to medicines for patients with rare, so-called ‘orphan’, diseases in the UK and other European countries. Commissioned by Shire Pharmaceuticals, it found that despite efforts at a European level to incentivise the research of new treatments for rare conditions and accelerate patient access, the UK has not kept apace with other countries.
“Speed of access to innovation has been recognised by Government as an area of focus for the life sciences industry post-Brexit”
R AC E FO R LI FE Speed of access to innovation has been recognised by Government as an area of focus for the life sciences industry postBrexit. In July, the new life sciences minister, Lord O’Shaughnessy, announced that there would be an extra £86m made available to boost uptake of technology and innovation in the NHS as part of the long-awaited implementation of the Government’s Accelerated Access Review (AAR), which originally kicked off in early 2015. O’Shaughnessy said: “The Government’s ambition is that NHS patients get worldleading, life-changing treatments as fast as possible. That can’t happen unless we support medical innovation and tear down the barriers, like speed to market and access to funding that can get in the way, especially for SMEs.” The Government’s position and narrative are encouraging, although the funding announcement offers only an element of the changes recommended in the final AAR report. It is also tightly focussed on SMEs and funding for the Academic Health Science Network; regional bodies that are intended to open up collaborations between the NHS, academia and industry. Hope is now being pinned on the direction and contents of the forthcoming Government Life Sciences Industrial Strategy. This plan,
first mentioned in the Government’s broader Industrial Strategy Green Paper, published in January 2017, intends to make the UK the best place in the world to invest in life sciences, with comparatively rapid access to new medicines being a critical part of achieving this ambition. In addition, the House of Lords Science and Technology Committee has now opened an inquiry into the Life Sciences Industrial Strategy. It specifically asks whether the Government has structures in place to support the life sciences sector, how the NHS can use procurement to stimulate innovation and if the content of the new strategy, when published, will effectively contribute to this. According to the Committee, the UK life sciences sector contributed £30.7bn to the economy in 2015 and supports over 480,000 jobs. Pharma will need to successfully make the case that speed of patient access is essential, not only to improved health outcomes for UK patients, but in terms of decisions to invest in the UK. Government will need to show that it is genuinely open to widespread reform and willing to reimburse approved innovation at as quickly as other comparable countries.
TIME WASTING Of the medicines used to treat rare diseases that received a license by the European Medicines Agency between 2001 and 2016, the average time to reimbursement in France and Italy was 19 months on average. It was almost immediate in Germany, due to how its health system appraises such products. In England it takes 28 months. Moreover, there are concerns among patient organisations and manufacturers about new rules for NICE’s Highly Specialised Technology (HST) process. They will introduce new thresholds for cost-effectiveness and a cap on the acceptable total annual cost to the NHS in England, causing further slowdown and possibly shutting out access to some new medicines.
Alex Ledger is Deputy Managing Director at Decideum – the views expressed here are entirely his own. Go to decideum.com
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They told her to leave university, she wouldn’t, they told her it was hopeless, it wasn’t, they told her she would die, she didn’t. This is Juno. INTERVIEW BY
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COFFEE BRE AK
ne cannot help but be in awe of anyone that faces down stigma and emerges victorious on the other side. My guest today epitomises the strength and fortitude which sends boorish and bigoted attitudes back to the dark ages. It’s not about daring to be different, but about being yourself, as we’re about to find out. What are you up to, Juno? I divide my time between Spain and England. At my place in Spain I can write and build campaigns with no distractions. I come back to carry out campaigns in Britain, and I’ve also got a book deal and am working on some films about the trans community. What is the sexual healthcare situation for trans people? I’m a transwoman and I’ve been HIV positive for 25 years. When you’re trans and HIV you have very fractured healthcare. I would go to my HIV doctor and ask about hormones, or to my gender doctor and ask how my hormones interact with HIV medicine, and they’d say, ‘I don’t know anything about that’. I would also ask my GP how it’s possible to have safe sex as a transwoman and they wouldn’t know anything either. It struck me that the dots were clearly not joined up. What are the consequences? The rates of infection for transwomen are still very high. If you’re a transwoman, you’re 49 times more likely to contract HIV than any other group and it is estimated that 19% of all transwomen worldwide are HIV positive. From my own experience, I am quite privileged; I work, write and have access to free healthcare in England, which means my HIV meds and gender
“When we band together we BECOME POWERFUL – trans people are proud of who they are and no longer willing to hide”
realignment have been provided. The way transwomen are treated on the NHS, however, needs considerable work. How are you helping to change this environment? A couple of years ago I looked at trans people in education; teachers and pupils. This involved putting on round tables and getting funding for outreach work. The Paul Hamlyn Foundation supported this drive and we put on events called ‘Finding My T-Spot’. This helped to push research, because there is no data in this country about trans people and HIV, and last year, I put on an event at Gilead, establishing what we needed to discover. Sounds like pioneering stuff. It was attended by Valerie Delpech from Public Health England, several senior consultants in the country, transactivists and the media. An advisory committee emerged, which looked at all the research going on involving trans people and sexual healthcare, and from that came two research projects which look at the sexual healthcare experience of transwomen in this country. How has this evolved? I am patron of the sexual healthcare charity cliniQ, one of only two centres solely devoted to trans people. I received a pot of funding, in order to do
outreach work, and now we’ve trained all the GPs in the South East, and staff from several sexual health clinics across the UK. I have also made the ‘Finding My T-Spot’ cliniQ film, which is designed to highlight the work to areas outside London. I am now looking to make a film specifically about transwomen who are HIV positive. How can the health risks to trans people be reduced? People talk about trans people as being a high-risk section of society, but no one group in society is inherently risky. What does pose a risk is the inconsistencies in healthcare structures. The gaps between GP, gender clinician and HIV clinician mean they don’t have shared knowledge, and that’s where people fall through the cracks. We still have people turning up at cliniQ with AIDsdefining illnesses, because they're not being picked up early. It seems that healthcare professionals urgently need an upgrade in this area. Time and time again I’ve heard GPs saying, ‘I’ve never met anyone like you’, and I feel like saying, ‘Well I’ve never met a 64-year-old GP with those particular spectacles before’. It’s not good enough - part of their remit is to know about me, and I hope through the legacy of the work I’m doing, a more cohesive network will be created. It is noticeable in the last few years that trans people have emerged from the shadows. For a long time, we were presented as victims and even classified as having a mental illness. That made it easy for people to categorise us as second-class citizens. In turn that placed us in a very passive position in relation to our healthcare. A decade ago, trans
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COFFEE BRE AK
people lost their jobs or were denied access to their children, but recently the community has said enough is enough and that there are laws to protect us. When we band together we become powerful; trans people are proud of who they are and no longer willing to hide. Has this strength been fortified by the years of adversity? It’s incredibly empowering to decide that what people see isn’t quite what you are, and make changes to address that. Subsequently, there has been a further kickback against our fight, and people want to question whether we can be ‘real women’, but I won’t go there anymore – there is more important work to be done, like ensuring people are living safe, aspirational lives. I’m not having the argument about whether I should exist anymore. You’ve lived a quarter of a century with HIV, Juno, that’s an incredible achievement. I know, I should be presented with some kind of medal, or a nice hand bag. When I was told I was HIV positive, I had a partner who was extremely ill. I was given a form, which said I was expected to live six months and entitled to death benefits. It was a time when there were no HIV clinics, just rooms at the end of long corridors. There were no nurses willing to take your blood, because they didn’t want to go near you. That’s unbelievable. People thought we were the scum of the earth. You couldn’t even get a dentist. When I did find one, it was the last appointment of the day and he would literally cover the entire dental surgery in cling film. Even friends would check which glass I was using and people like Edwina Curry were saying that no morally upright person needed to worry about AIDS. The stigma was colossal, but I’m still here, and as entitled as anyone to have dreams and laughter in my life. In a way, it made me who I am today. How on earth did you survive? I started to set myself goals. I was in the first year of university when I was diagnosed and they wanted me to leave, but I thought ‘If I’m going to die, I’m going to die with a degree certificate in my hand’. I lived long enough to get my Masters and, by that time, I thought ‘Actually, I don’t want to die’. Then the new drugs started to come out, which we could
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“I am a positive person, and love being alive.
When did you decide to become a trans woman? I had made the decision years ago, but because I was HIV positive GPs and PCTs would turn me away and no one would fund the procedure. Then one day I was accepted and had the surgery. It’s incredibly liberating to feel like you’re truly being yourself. Most of our lives are segmented, blocked and labelled, but I won’t be in any kind of closet.
THE WORLD IS A WONDERFUL PLACE
You must be proud of your part in the trans revolution. Whenever there is a group of people that are marginalised, eventually they come together and mobilise. When the abuse stops hurting, you start to fight back and build structures that look after you, because no one will do it for you. Hopefully, through my work, it’s beginning to happen with trans people and HIV.
trial, and the years started to clock up. I am a positive person, and love being alive, and was like that even before my diagnosis. The world is a wonderful place and I wanted more of it. I have continued to challenge myself, like moving to Spain among the mountains, in the middle of nowhere.
What record would you choose for the soundtrack of your life? This sounds completely corny, but it would have to be ‘Changes’ by David Bowie. One of my dearest friends, who was among the first to die of AIDS, in the late eighties, introduced me to Bowie. I don’t miss many people, but I miss that friend’s joy for life and what they would have brought to the world.
and I wanted more of it”
What prejudice are you encountering in 2017? I wrote a series of pieces that studied online dating, so I joined Tinder. As an experiment, I started by only putting an image of me on the site. As a result, I got lots of comments, mainly from younger men, who said they ‘liked older women’. I thought, ‘Bugger off’, but at least it was supposed to be complimentary. Then I added that I was a transwoman, and still received a lot of interest. Finally, I revealed I was a transwoman living with HIV, and was bombarded with anger, aggression, threats and ignorance. Instantly I became a bad person. The stigma is still there. What treatments have you been on over the years? In the early days, I went through a whole gamut of new drugs, with all sorts of extreme side-effects. Now, it’s easy to adhere. I’ve been on Truvada and Nevirapine for years, and been undetectable and well for as long as I can remember. I’ve always been very motivated to be on top of my own care – asking questions and making sure I was comfortable with the medication I was on, and able to thrive on it.
It’s your last supper, what are you having? My homemade mushroom risotto, with lots of good parmesan. Sounds delicious. Goodbye, Juno. Bye John.
MAKE THAT CHANGE If you are a transgender person, thinking of transitioning or want more information about subgroups within the trans community there are several very useful online platforms providing advice, support and inclusivity. Trans adults: gires.org.uk Advice and support: transgenderni.com Self-help and social: beaumontsociety.org.uk Trans law: pfc.org.uk If you’re working in pharma, and you think your company could be doing more in this area, why not visit cliniQ, the pioneering sexual health centre for trans people. Head to Dean Street in Soho or visit cliniq.org.uk
JOIN US: QuintilesIMS duo Andrew
Wilkinson and Samantha Prindiville on the company’s unique culture and forging a career in medical sales.
escribe the QuintilesIMS culture. Integrity is at the forefront, and the company does what is right for employees, clients and patients. Employees take ownership of their performance and are accountable for achieving our goals. The company has an ambitious growth strategy and we work cooperatively across teams to enable client success and drive service. We also work in an environment that seeks to balance professional aspiration with personal lifestyle. How does the company reward highperforming employees? QuintilesIMS has processes which recognise employees, and our pay-for-performance culture means they are rewarded, and encouraged to continually grow. This contributes to the success of the company and produces an innovative place to work. What opportunities are there for employees to progress? We have an internal, global careers
“It’s about putting your customer first, thinking about the challenges they face and how you can help them”
site which encourages employees to manage their own destiny! QuintilesIMS is passionate about career development. In the commercial business for example we have many employees who started their careers as medical representatives and now work in senior management/ market access/medical education roles. What is the key to employee motivation? It is highly motivating for employees to know that everything we do helps our clients improve patient health. We are also among great experts and leaders, which creates fantastic camaraderie. What is it like having a career in the medical sales industry? Having the chance to make a genuine difference to people’s lives. As medical representatives we work with a range of healthcare professionals to make sure patients receive the right treatment at the right time. It is a real ‘driver’ for getting out of bed on a Monday morning!
What is the state of the market at present? QuintilesIMS excels in sourcing high-calibre candidates. The company really cares about retaining quality people and this makes a significant difference in attracting candidates and helping them to differentiate between prospective employers. How is the market expected to change in the future? As the landscape changes, budgets and access to medicines will become more localised and companies will implement integrated solutions. Highly-skilled roles will have the ability to operate and engage with divergent organisations, enabled by technology platforms. More flexible promotional and non-promotional resources will also help to drive partnerships with local healthcare providers. What does it take to succeed in the market? You need passion, courage and the ability to work well in a team. It’s about putting your customer first, thinking about the challenges they face and how you can help them. If you want to make a difference with QuintilesIMS, take a look at our range of Medical Sales jobs. Samantha Prindiville is a Recruitment Consultant and Andrew Wilkinson is a Medical Sales Director with QuintilesIMS. Go to commercial-careers.quintilesims.com
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ales force effectiveness (SFE) is about helping representatives to become as effective and efficient as they can be in today’s increasingly complex, demanding and competitive marketplace. With increasing pressure from senior management and brand teams to maximise return on investment (ROI) from this expensive resource – and in many cases to reduce promotional spend and still achieve at least the same results – the focus on SFE or return on investment has never been greater. M E A S U R E O F E F F E C TI V E N E S S If you were to ask 10 companies how they measure SFE, you would probably get a different answer from each, and even different answers from within the same company, dependent on who you asked – but generally they tend to comprise a combination of efficiency and effectiveness measures. Efficiency measures typically look at the more objective areas, such as calls per day, coverage, frequency of calling on target customers and cost-per-call – whereas true effectiveness measures consider the impact of the representative’s behaviour on prescribing. Key questions that traditional SFE initiatives ask include: • A re sales materials communicating messages appropriately? • D o the key messages drive prescribing? • How effective are the representatives in delivering key messages? • A re the messages differentiated against those of the competitors? • W hat activities should we be teaching representatives to do better? • What SOV (share of voice) is being achieved? • W hat is the optimal call frequency? • W hat results (for example, share increase) are calls getting?
“Good SFE can ultimately develop the trust between pharma and the HCP”
B R A N D A L I G N M E NT Increasingly, however, there is a move towards optimising and aligning the brand strategy with the patient and healthcare professionals (HCPs) through all aspects of the company’s sales and marketing effort. The first step in this process is a marketing audit that would typically ask: • W hat percentage of people know and have belief in the brand strategy and to what extent do you lose traction the deeper into the organisation you go? • W hat is the belief in the brand messages, core story and materials, and how do materials get used as customers react to them during selling situations? • How aligned are people on the target patient? • I n what percentage of calls do field-based people really engage the customer? • How often is there a clear outcome to customer interactions where customers can see a value from having had the interaction and a clear behavioural change agreed? Following the marketing audit, which is normally carried out by an external provider and can provide benchmarks with industry averages, recommendations are made in respect of a numbers of areas, and an implementation plan agreed to address the highlighted areas. To achieve optimal sales force effectiveness, companies need to ensure they are delivering the right messages to the right target audiences with the appropriate influencing behaviours.
S TR O N G P R O P O S ITI O N To be truly effective, today’s representatives need to understand the NHS and local Health Economy agendas in more detail than ever, and they also need to be able to articulate a strong value proposition for the product they are selling to an increasingly diverse range of stakeholders. When interactions and key messages are tailored to the needs of the HCP, their patients and practice or department are much more likely to respond with a prescription or recommendation for the product. Good SFE can ultimately develop the trust between pharma and the HCP, but it is essential that patient-centricity and a strong value proposition are at the heart of the call for this to play out in practice. If pharma company brand teams and their field sales teams fail to address this, they are likely to significantly reduce their in-call effectiveness, and worse still, run the risk of alienating these important customers, and diminishing the value that pharmaceutical companies can add. R E S U LT S B U S I N E S S Ultimately, successful SFE initiatives will realise increased sales returns, or reduced promotional spend to yield similar or better results. It will result in more effective customer targeting, enhance the impact of each HCP interaction, develop a truly performance-based field sales team and enable an efficient, effective and joined-up sales and marketing effort across the whole organisation. Go to ashfieldhealthcare.com
Karen Bell, Director of Business Development at Ashfield Commercial and Clinical UK, on maximising return on investment. W O R D S B Y Karen Bell
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WHY WE INVENT We are not inventing for invention’s sake – we are on a quest to cure – and to have an impact on countless people’s lives worldwide. MSD is inventing because the world still needs cures for cancer, Alzheimer’s disease, HIV, and so many other causes of widespread suffering in people and animals. We are taking on the world’s most challenging diseases to help people go on, unburdened, to experience, create and live their best lives.
SALES FORCE AWAKENS
To explore our commitment to invention, visit www.msd-UK.com and connect with us on Twitter @MSDintheUK.
Copyright © 2017 Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc. Kenilworth, NJ, USA. All rights reserved. Merck Sharp & Dohme Limited. Registered Office: Hertford Road, Hoddesdon, Hertfordshire, EN11 9BU. Registered in England No. 820771. CORP-1229253-0000. Date of preparation: August 2017.
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Words of prophets on surgery walls Patient data is king and pharma companies should ignore it at their peril.
ast month I suggested that primary care delivery needs to radically change or face the consequences, so it was interesting to get an email from a colleague last week about a 22,000-patient practice in Plymouth, where the partners had given up the contract. The core business of pharma lies in primary care practices. I sense fewer field-based people now have a relationship with a practice where they can sit down and say ‘How’s it going?’ That kind of informal chat, whether with a GP, practice manager, pharmacist or practice nurse, leads directly to understanding business drivers at the point of prescription. There is no substitute for getting close and understanding what happens when patients and HCPs meet. That understanding can also be supported by some excellent sources with the potential to be developed into highlyvaluable business analysis. Personnel on the ground need access to local NHS information, while using it to their advantage without getting lost in a sea of data. Field-based teams are often swamped by stuff on their screen, which they feel obliged to somehow use, but can’t see the relevance of it. The NHS recently published the annual GP Patient Survey. This is a great resource for anyone in pharma, from strategic development to the representative on the ground. I do wonder how much it features in current discussions within companies though. Some praise is due to NHS England for developing this over the years and funding such a massive piece of user feedback. What we have is a goldmine of information going back years, and with sound methodology. The range and depth of questions means that all kinds of revelatory trends are available by practice, CCG and across the national scope.
OUR SURVEY SAYS
The GP patient survey is an independent survey run by Ipsos MORI on behalf of NHS England. Data is collected across three months, involves 23 different ratings and published on an annual basis. The categories include ‘ability to get appointment’, ‘confidence in GP’ and ‘satisfaction with nurses’.
84.8% RATE THEIR OVERALL EXPERIENCE OF THEIR GP SURGERY AS GOOD
77.4% say they would DEFINITELY OR PROBABLY
RECOMMEND THEIR GP
1 in 5 PATIENTS
SAY WHEN THEY TRIED TO SEE A GP THE SURGERY WAS CLOSED 53.5% OF ALL PATIENTS HAVE ONE OR MORE LONG-STANDING
HEALTH CONDITIONS Go to gp-patient.co.uk
You can read it anecdotally, so that it tells a story with a distinct narrative and you can use the data as spreadsheets for statistical analysis. If you doubt the method then just look at one familiar practice and I bet you’ll see a true reflection of that organisation. The overall results and the practicespecific data show a system that is changing fast, but not as fast as its users are changing, and certainly not as fast as its users would like it to change. Just one of the fascinations for me is to see how patients have driven online communication with GP practices and, especially, seeing how that mixes through demographics. This should be mandatory reading in the field and in the board room. David Thorne is Chair, Washington Community Healthcare and Non-Executive Director, City and Vale GP Alliance. Go to blueriverconsulting.co.uk
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F E AT U R E WORDS BY
Does being tall increase your risk of prostate cancer? Don’t believe the hype: health headlines dissected TH E S TO RY
TH E D E A L
Around one in eight men will get prostate cancer at some point in their lives. As with any disease it has certain risk factors, but recently the British press reported that being tall could make men more likely to die from prostate cancer. A large study by researchers at Oxford University investigating the association between height and being overweight was behind the reports, but what’s the truth behind the headlines?
The study found that increased height was not associated with overall risk of contracting prostate cancer, but only with aggressive forms, and researchers stressed that height alone was not associated with overall prostate cancer risk. Lead researcher, Dr Aurora Pérez-Cornago from Oxford University, said: “The finding of high-risk in taller men may provide insights into the mechanisms underlying prostate cancer development. For example, related to early nutrition and growth. “We also found that a healthy body weight is associated with a reduced risk of high-grade prostate cancer and death from prostate cancer years later.” Prostate Cancer UK pointed out that the incidence of taller, obese men contracting the aggressive forms of the disease was not as high as papers stated: ‘The increased absolute risk of dying from prostate cancer for the tallest men in the study was only approximately 0.28 per cent’. Prostate Cancer UK’s Deputy Director of Research, Dr Matt Hobbs, added that the study’s usefulness lies in finding out why the disease develops: “It might provide pointers to help uncover certain genetic markers and early developmental processes which hold significance.”
TH E R E S E A RC H Researchers at Oxford University investigated the association of height and adiposity (severe or morbid overweight) with incidence of, and death from, prostate cancer in 141,896 men in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. The team found that the risk of high-grade disease and death from prostate cancer increased by 21% and 17% respectively with every additional 10cm (3.9 inches) of height.
TH E R E S U LT S Despite the headlines, aimed at scaring any men over 5 feet 11, the results showed that height alone was not associated with total prostate cancer risk. Of the men, 932 died from prostate cancer overall. This total includes 159 of the shortest men (under 5 feet 6 inches tall) and 227 of the tallest men (over 5 feet 11 inches tall). What the study did show is that the risk of aggressive forms of the disease and death ‘increased by 21% and 17% respectively, with every 10cm increment in height’, but those men also had ‘greater adiposity’. “The findings show that men who are taller and have greater adiposity have an elevated risk of high-grade prostate cancer and prostate cancer death,” concluded the researchers.
W HAT TH E PR E S S SA I D : “Boys, your height could predict if you’ll die from prostate cancer” thesun.co.uk; “Tall men at greater risk of death from prostate cancer” telegraph.co.uk
IN THE UK IN there were
46,960 new cases of
PROSTATE CANCER &
DEATHS from the disease *
AVERAGE height of
*Source: Cancer Research UK
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GOOD & PILL
How can industry take corporate responsibility from concept to mainstream? WORDS BY
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“Companies are used to longterm plans and commitments when launching medicines so why don’t they do the same for sustainability strategies?”
harma strategies around Sustainability, Purpose, Corporate Social Responsibility (CSR) and Access to Medicines are too often confused. For years, many companies have created a hard separation between the CSR side of the business and mainstream commercial business. ‘Doing good’ and ‘selling medicines’ have somehow been seen as separate activities. But the world is changing fast and pressure to change is coming from all sides. The millennial workforce is demanding to work for organisations that ‘make a difference’, emerging countries are looking for pharma companies who genuinely want to partner and progressive boards have realised that sustainability is not a fad, but an integral part of growing their business. For companies and organisations that make up the pharma industry, the vision, mission and strategy are normally clear. Behind the desk in reception, on the walls around the business and on employee screensavers the organisation’s critical messages ensure everyone is living and breathing the corporate strategy!
While the company strategy is rigorously cascaded through the organisation into brand strategies, functional strategies and marketing plans, the one area where there is often inconsistency is in CSR. Flicking through the list of activities that have been supported by the CSR or sustainability team is to find a smorgasbord of excellent initiatives supporting needy causes, but it is essentially an activity list. These initiatives often stand apart from the strategies and skills of the business. Too often the programmes are chosen to reflect the short-term interests of senior management teams and are supported with a donation, normally handed over with a few photos for the annual report. While such causes are almost without exception worthy and important, it makes no sense. Companies are used to long-term plans and commitments when launching medicines so why don’t they do the same for sustainability strategies. This would also apply to recipients and good causes; long-term commitments make far more sense than irregular donations, while impactful interventions also require planning and first-class implementation.
F E AT U R E
D I R EC TI O N O F TR AVE L
harma companies increasingly view access to medicine as a way of developing their business in emerging markets and there have been compelling examples of big industry names changing how they use their pioneering products. AstraZeneca’s signature public health support programme, ‘Healthy Heart Africa’, is run in partnership with the Kenyan and Ethiopian Governments. With co-funding from USAID, it runs awareness campaigns, strengthens health systems and makes sure low-price anti-hypertensive medicines are available in programme sites. With over three million screenings, 3000 healthcare professionals trained, 500 facilities mobilised and training curriculums written, it is providing support at scale; support that the Ministry of Health appreciates. It is a genuine partnership; every piece of material used in the programme is co-branded with the Ministry of Health logo. Novo Nordisk has run its ‘Base of the Pyramid’ programme for a number of years, also working with the Kenyan Government, running awareness campaigns, strengthening health systems and providing low-cost insulin through the Christian and Catholic Health networks. In addition, Novartis and Takeda are making steps to develop their capability in these areas, creating new non-communicable diseases programmes and setting up wider collaborations, while GSK still top the access to medicines index for their broad approach to sustainability and access to medicines. Emerging collaborations are wider still. New collaborative research models are also supporting medicine development for the most burdensome diseases in low and middle-income countries and new sources of funding are coming on stream to partner with pharma companies on manufacturing volume guarantee schemes. In June the UK Government’s Development Finance Institution, whose mission is to support the building of businesses throughout Africa and South Asia, announced a new five-year strategy that included investments focusing on pricing and access to medicines. The journey is at the early stages, but the big message is clear. If you want a business which operates on a long-term basis, think long-term and ensure your sustainability strategy is at the heart of it. Your patients, employees and shareholders will thank you for it.
TALK I N G S H O P: SUSTAIN IN G SUSTAINAB ILIT Y It makes sense that forward-looking pharma companies are taking sustainability out of CSR and into the mainstream business. Sustainability, after all, is proven to work in tandem with overall business aspirations in other industries. Unilever, for example, has been consistent thought leaders in this area: • It sells fish, so the fish business supports fish preservation (Marine Stewardship Council) • It sells tea, so the tea business supports sustainable plantations (Rainforest Alliance) • It sells products to wash hands, so it encourages people to wash their hands to reduce infections (‘WASH’ programme with the Kenyan Government).
PR E S E NT DAN G E R : D O NATI O N S M UST CO M E WITH ED U CATI O N Bizarrely, CSR departments currently have rules preventing them from supporting and aligning with the business. What will also surprise many is that African governments, NGOs and facilities are also against medicine donations, though there are clearly exceptional circumstances when they are required. What they need is long-term low prices, a stable and well managed supply chain and support on health system strengthening. Donations distort markets and don’t help patients appreciate the value of medicines. If a patient doesn’t value a medicine, they are unlikely to take it or adhere to the treatment path. When a village in Nigeria was offered free mosquito nets, the farmers took as many as possible, and used them to build fences for their chickens and livestock. They were so pleased with the ‘free gift’ that they completely forgot to use them for sleeping under. In contrast, when a similar village was educated on malaria prevention and charged $1 a net all the villagers purchased a net and used them for their intended purpose. Ultimately, the UN’s 2015 Sustainable Development Goals has set out the challenge for global health, recognising that there are trillion-dollar funding gaps to solve. Innovative partnerships and collaborations between non-traditional partners, pharma companies, governments and global foundations are clearly regarded as part of sustainable solutions.
“Donations distort markets and don’t help patients appreciate the value of medicines. If a patient doesn’t value a medicine, they are unlikely to take it or adhere to the treatment path.” M AG A ZI N E | S EPT EM B ER 2017 | 2 3
ne in five men will die before the age of 65. Men die on average six years earlier than women. Suicide is the leading cause of death among men under 45. These are stark statistics, yet men apparently still find it more difficult than women to seek help when they have health worries. What is being done to change men’s attitudes to health? B OYS W I L L B E B OYS Dr Mark Street is a GP who has worked in the NHS and private sector for 26 years and has a private practice at Spire Parkway Hospital in Solihull. “I have noticed the unwillingness of men to go to their GP and talk about health matters. I often see male patients who have reached a stage when their partner is asking them to seek help,” he says. “Many are suffering symptoms, such as lack of sleep, mood swings, lower performance at work or relationship issues. Yet despite being concerned they allow the situation to worsen.” An EU–wide report, ‘The State of Men’s Health in Europe’, addressed the reasons behind why men are less likely than women to visit their doctor or pharmacist, and found that it could be down to the influence of
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culture on the shaping of masculine identity. From an early age, the report states: ‘Boys learn not to show physical or emotional vulnerability, and they are encouraged to strive for achievement and success.’ It adds, ‘fear surrounding the potential loss of masculinity may result in a façade of control and stoicism, instead of honesty about reporting symptoms or openness about feelings and insecurities associated with particular illnesses’. Meanwhile, according to a report cited by the Men’s Health Forum: ‘Health is often socially constructed as a feminine concern.’ So-called ‘health literacy’ is also an important factor, and there are not only differences in health literacy levels between men and women, but between men of different socio-economic groups. A 2017 report from the OECD, ‘Understanding the socio-economic divide in Europe’, found that: ‘Men with lower levels of education have 2.7 years less life expectancy than the better educated’. This is due to various factors; a King’s Fund report found that men are not only more likely to indulge in four risky behaviours such as smoking, excessive alcohol use, poor diet and low levels of physical activity – but that professional men were least likely to have three or four unhealthy behaviours and unskilled men most likely to have them.
G E N E R ATI O N A L D I V I D E Karen Stalbow, Head of Policy, Knowledge and Impact at Prostate Cancer UK, says that the charity’s research shows that men sometimes don’t see the point of worrying about ill health, despite the risk of ignoring it: “There are several factors that stop men who are at higher than average risk of prostate cancer from recognising their risk. Some men we spoke to thought it wasn’t worth worrying about exactly what illness you’ll get. They preferred instead to just deal with it when it happens. This means they will likely only address issues if they show symptoms, unless directed by a GP.” Dr Street points out that there may be a different attitude among younger male patients thanks to greater access to digital information: “I personally think younger men are accessing their GPs more than other age groups due to a heightened awareness of health problems through social media and the internet.” Karen says, however, that men are more likely to seek help for health concerns the older they get: “We know that some men can be reluctant to visit their GP with health concerns, but recent research we undertook showed that, as they get older, men can become more likely to act quickly when they notice changes in their body.”
WOMEN IN THE 20-40 AGE GROUP
attend general practice AS OFTEN AS MEN
OF WOMEN TELL SOMEONE ABOUT GOING THROUGH DEPRESSION
55% of men do the same
F E AT U R E
Why are men often reluctant to seek help for health worries? W O R D S B Y Amy Schofield
H E A D S PAC E Data from the Samaritans Suicide Statistics Report 2017 reveals that the highest UK suicide rate was for men aged 40–44, and that male rates across the UK remain three times higher than female rates. The 2016 ‘Masculinity Audit’ from male suicide prevention charity, Calm, found that men are less likely than women to tell friends about being depressed, and doctors may not spot danger signs. The tide may be turning, however, thanks to campaigns such as Time To Change’s ‘Be In Your Mate’s Corner’ campaign and the young Royals’ charity Heads Together.
“Mental health issues are perceived as a weakness by male patients and many are reluctant to ‘open up’ to their partner or GP” Time to Change, the mental health campaign run by charities Mind and Rethink Mental Illness, carried out research into men’s attitudes towards mental health over the course of a year, which included feedback from 18 focus groups. This insight revealed barriers preventing men from opening up. Men are less likely to report their own experiences of mental health problems, less likely to discuss them with a professional and more likely to say that mental health problems are the result of a ‘lack of self-discipline and willpower’. A negative perception of mental health problems may be a reason why men don’t seek help, according to Dr Street: “Often mental health issues are perceived as a weakness by male patients and many are reluctant to ‘open up’ to their partner or GP as they see this as being a failure,” he explains. Men, it’s time to talk as if your lives depended on it.
1 in 7 37% HIGHER
MEN HAVE A 14%
HIGHER RISK of developing cancer & a
risk of dying from cancer.
MEN IN THE UK DIE FROM
Sources: NHS Information Centre; Calm; The State of Men’s Health in Europe report; bhf.org.uk
U S E FU L W E B S I TE S menshealthforum.org.uk prostatecanceruk.org time-to-change.org.uk nhs.uk chaps.uk.com uk.movember.com
M AG A ZI N E | S EPT EM B ER 2017 | 2 5
After the STI awareness drives of the 90s are we less drawn to risky sexual behaviour and more willing to get tested?
STUDYING B EHAVIOUR D R H E LE N WE B B E R LE Y GP, sexual health expert and runs mywebdoctor.co.uk
he 1960s brought sexual liberation and effective methods of non-barrier contraception, but this had unintended consequences and by the 1980s sexually transmitted infections were front-page news.
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Once we began to understand the range and threat of infections that could be passed on sexually, many people took stock of the risks. The more cautious chose to adopt a ‘double dutch’ approach – taking one method of contraception for preventing pregnancy and another for preventing infections. The extent to which fear, and the risks involved, actually changed habits of sexual activity is largely unknown. What we have seen, however, is a marked increase in the acceptability of getting tested – both among healthcare professionals and patients. You can now have a full STI check done at your local GP surgery using a simple urine and blood test. You can also buy discreet home-testing kits for those who would rather keep it private. Many youngsters go hand-in-hand to the genitourinary medicine (GUM) clinics for their check-ups and proudly show the results that appear on their smart phone to mates and prospective partners. GUM clinics have joined with contraception
exually transmitted infections (STIs) always take the award for ‘most embarrassing condition’. The socially awkward nature of STIs has resulted in campaigners, charities and governments being compelled to use awareness-raising campaigns that shock, entertain or inform in increasingly innovative ways. It is also an area in which pharma is compelled, not just to keep the disease landscape in sharp focus, but to examine how society changes, shifts and moves with the times. Here, experts from across the sexual health landscape share their thoughts on where we are with STIs and sexual health, and where we should be in the future.
services to form united, open and friendly one-stop shops for improved sexual health. Sexually transmitted infections do still pose a real threat, however. We are seeing strains of gonorrhoea that are resistant to antibiotics, and the re-emergence of syphilis. Despite effective treatments for HIV, it is still a life-altering threat to both heterosexual and homosexual couples, and will continue to be so while the promise of bare sex continues to be considered a ‘treat’. Once contracted, genital wart and herpes viruses stay permanently, emerging as unsightly sores or lumps, while infections like chlamydia go unnoticed until the damage to the host’s fallopian tubes are revealed. So, while sexual habits continue to be free and easy, even though we have new treatments becoming available, those who see the damage still concur that prevention is better than cure. Prevent the infection from getting into your body, rather than celebrate the negative results from your last trip to the GUM clinic, as next time you may not get the all clear.
F E AT U R E
PICTURE OF HE ALTH CARY JAM E S
Head of Health Improvement at Terrence Higgins Trust
his year marks 100 years since the Venereal Diseases Act was passed by Parliament, marking the beginning of free, confidential and professional sexual health services in the UK. Since then, vast strides have been made to ensure people can enjoy good sexual health, including the latex condom and oral contraceptive pill. But we have faced challenges, most notably the AIDS crisis. Sexual health and HIV campaigns have changed vastly since those days. Back then, the Government’s AIDS campaign, famous for its imagery of tombstones engraved with the words ‘AIDS: Don’t die of ignorance’, was not to everyone’s tastes, and has, with hindsight, left a legacy of stigma, because there hasn’t been anything since to update people’s knowledge. But it did save lives. Medical advances in HIV treatment now mean the virus doesn’t have to stand in the way of living a long and healthy life. But we cannot underestimate the impact of stigma. It stops people getting tested, because they fear reaction from friends and family if they are diagnosed, and this means there are thousands of people living with HIV who don’t know and could unwittingly pass on the virus. To help combat this, we use empowering messages in our prevention campaigns because they work better than scaring tactics – our messages are about celebrating individuals who are taking small but powerful actions to stop HIV and enjoy good sexual health. And these are working. This year we’ve seen the first ever drop in new HIV diagnoses in gay and bisexual men. We still have much to do, however, in addressing the nation’s poor sexual health. STIs have dropped by 4%, but are still unacceptably high. Some STIs are still increasing; in 2016 we saw the highest rates of syphilis since 1949. There are still particular communities that are
“We cannot underestimate the impact of stigma. It stops people getting tested, because they fear reaction from friends and family” bearing the brunt of poor sexual health. Young people, black and ethnic minority communities, people living with HIV, and gay and bisexual men continue to be disproportionately affected by STIs. This is not acceptable; good sexual health should be a reality for everyone. From 2019, relationships and sex education will be mandatory in all schools, which gives us a huge opportunity to tackle STIs in young people. For this to have an effect, however, it must include information about STI testing, LGBT sexual health and confidence in negotiating condom use – not just heterosexual sex and reproduction. We need the government to fully fund sexual health services and make prevention, including HIV and STI testing and sexual health information, as simple and accessible as possible, wherever you live in the country. It is essential that Public Health England, the Department of Health and local authorities ensure improved access to effective STI and HIV testing, treatment and prevention services. Only then can we achieve our vision to end the HIV epidemic, and promote good sexual health. The Terrence Higgins Trust is currently running two compelling campaigns. ‘It Starts With Me’ aims to cut new HIV infections though condom promotion and the reduction of undiagnosed HIV infection through increased testing. ‘Can’t Pass It On’, is a stigma-busting campaign, highlighting that people on effective HIV treatment can’t pass it on. Go to tht.org.uk
STIs are acquired every day
1in 4 every year
STIS EITHER CHLAMYDIA,
GONORRHOEA, SYPHILIS OR TRICHOMONIASIS
PEOPLE ESTIMATED TO HAVE GENITAL HERPES
WOMEN with a HUMAN PAPILLOMAVIRUS (HPV)
INFECTION THE MAJORITY of STIs have
NO SYMPTOMS OR ONLY MILD SYMPTOMS
GONORRHOEA DRUG RESISTANCE A
MAJOR THREAT to STI reduction Source: WHO
M AG A ZI N E | S EPT EM B ER 2017 | 2 7
F E AT U R E
RELE A SING P OTENTIAL D E B O R AH E VAN S
420,000 STIs diagnosed -
Managing Director of Pharmacy Complete
“Community pharmacies are part of the solution and are getting involved in broader STI testing”
LESS THAN 2015
12% diagnoses of syphilis -
more than 2015
MOST SYPHILIS CASES SINCE 1949
1.4 MILLION CHLAMYDIA TESTS CARRIED OUT
chlamydia diagnoses among people aged
15-24 STIs REMAIN GREATEST IN YOUNG HETEROSEXUALS, BLACK ETHNIC MINORITIES, GAY PEOPLE AND BISEXUAL PEOPLE Source: gov.uk
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ommunity pharmacy is an important setting for women to access emergency contraception, get advice on choices and receive treatment as emergency hormonal contraception (EHC). Around three-quarters of all EHC is acquired from pharmacies in England, either as a purchase from the pharmacist, with a prescription from their GP, or as a local enhanced service commissioned by the local authority. Providing EHC is a critical professional activity for pharmacists and pharmacy teams to ensure women in their care receive non-judgemental advice, support and a great experience; seeking emergency contraception can be a very anxious time for anyone. Undertaking an empathetic and person-centred consultation is essential to gaining trust and in doing so, provides opportunity to engage on other sensitive issues – exploring future contraception options and the possibility of an STI. With
so many EHC consultations undertaken in community pharmacy, this is the perfect opportunity to engage women in a conversation about testing for infection, and yet only 1% of all chlamydia tests are undertaken from a community pharmacy. One of the challenges affecting this take-up is how sexual health services are commissioned and the reduction in funding for sexual health, which we’ve seen in various local authorities across the country. Additionally, sexual health services are commissioned and provided by different parts of the health and care system, leaving the possibility for people to fall through the gaps. Since asking for STI screening help can be such a sensitive issue for individuals who are easily dissuaded from accessing services, we have to find a way of joining up with the person at the centre. Community pharmacies are part of the solution and are, in some more progressive areas, getting involved in broader STI testing in areas such as hepatitis B and C, HIV, syphilis and chlamydia.
P H A R M ATA L E N T
COUNTDOWN Claire Handley, National Recruitment Manager at Evolve Selection, offers a countdown to further boost your career.
5 4 3 2 1
Understand your own talents & competencies By taking the time to identify your own strengths and skills, you can tailor your job applications to match essential requirements for specific vacancies.
Sales & Marketing specialists in Pharmaceuticals, Healthcare and MedTech
Seek expert advice and guidance Whether youâ€™re just starting out on your career journey, or looking at how to make that next step forward; ensure you seek expert advice and guidance from experienced recruitment professionals within your specific market sector.
Ensure you apply for the right roles
Recruitment and Outsourcing
Applying for vacancies on a blanket basis will possibly just waste your time. Identify the roles which suit your skill set and competencies and then focus on more tailored applications around these.
Boost applications through job search Working with an expert niche market recruiter will add significant value to your job application, as they will provide the specific insight and knowledge you will need to ensure success throughout the recruitment process.
Always be honest, open & consistent Whether working with a recruiter, or directly applying to companies, itâ€™s essential that you are always upfront and honest. This will ensure a clear line of communication from both sides and help to simplify complicated recruitment processes.
M AG A ZI N E | S EPT EM B ER 2017 | 2 9
THE CHANGE MAKER:
Philipp Maerz is Chief Operating Officer at Allergopharma and will be making a speech on cultural transformation at the eyeforpharma event, Marketing and Customer Innovation Europe
OMPANY: Allergopharma’s core business is immunotherapy for allergies. It is a daughter company of the German Merck group, which is headquartered in Darmstadt.
TRANSFORMATION: I started in my current role a year ago, heading global commercial operations. Historically, we have come from a very customergeneric approach, where we used the same material for all customers. Now, using market research, we are focussing on the individual needs of our different prescriber groups, such as ear, nose and throat specialists and dermatologists. CULTURE: Our treatments are prescription drugs and this requires both the patient and the prescribing doctor to come into sharp focus. We have extended this, not just to sales, but throughout manufacturing, finance and the back office. It takes time to change the culture, but it does start to get into people’s minds. INDUSTRY: It used to be the pharma industry way to really push through the doors of the doctor’s office, but now it’s a multi-channel mix, with sales, medical liaison and remote detailing. Ultimately, we must appreciate what the customer wants and that shift is happening. INSPIRE: We have been working to change mid-size structures and there are many other companies out there who are stuck in a situation where not much has changed for years. Digitalisation and the change in healthcare professional outlook means they have to. I want to give people a unique insight into what we have managed to achieve.
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EYEFORPHARMA If you want to hear more from Philipp at eyeforpharma’s Marketing and Customer Innovation Europe event, please contact firstname.lastname@example.org or email@example.com, or go to social.eyeforpharma.com
P H A R M ATA L E N T
What does a
WINNER look like?
We ask past winners and judges of the Pf Awards what it takes to win a Learning & Development Award WORDS BY
Regular Pf Awards Judge
2017 Learning & Development Award
The first challenge is to identify important performance objectives within your organisation, agree upon capabilities which deliver desired outcomes and then diagnose specific skill and knowledge gaps. The second challenge is to devise, implement and monitor an innovative, stimulating and enjoyable L&D strategy which supports your participants.
The Pf Awards are a fantastic opportunity to showcase our work as L&D professionals. To be successful you need to demonstrate leading-edge design and delivery of learning which, in turn, helps individuals grow. This increases engagement to deliver value for the patient and consumer.
P R E PA R AT I O N
The Assessment Day is both stretching and rewarding. It’s the moment when you can really bring your work alive and, therefore, it is vital to present what you are proud of in the allocated time. The assessors were really engaged and asked some great questions. My advice would be to think through what potential questions you might be asked and, above all, enjoy it.
P R E PA R AT I O N
ust what does it take to be the best? Winning a Pf Award is the ultimate accolade for individuals working in the pharmaceutical sales industry who want to test themselves against their peers and demonstrate how they perform under pressure. The Pf Awards have become widely recognised as the definitive achievement for representatives operating in the areas of sales and medtech. Winning a Pf Award represents a major career highlight and Pf Award winners go on to scale even greater heights in our highlycompetitive industry. In 2018, we’re introducing two entirely new Pf Award categories – The Best Newcomer Award and The CrossFunctional Team Award – bringing the total number of categories up to 15. Entries open in September. Go to pfawards.co.uk and take your first step to finding out what it really means to be a winner, just like GSK’s Peter Mulcahy, winner of the 2017 Learning & Development Award.
The L&D initiative judging panel expects professionals to deliver a well-structured and impressive presentation. If, as is often the case, the initiative is presented by two people, they should have rehearsed a seamless performance. L&D professionals inspire motivation within others through their own performance and the Pf judges need to be similarly inspired. WINNING
The key to success is exciting judges. We see many well-implemented but familiar strategies; our interest is aroused by something new. Learning is stimulated by challenging paradigms, while successful initiatives support the learning of different types of people, utilise technology and focus on the transfer of learning.
What worked for us was having the voice of our employees, who took part in our programme, and being able to confidently show how the programme made a real difference to their career development.
The benefit of winning a Pf Award is raising your profile, both within your organisation and the industry. For L&D professionals, however, I believe that personal satisfaction comes from seeing others develop and succeed as a result of your interventions.
I am so proud of receiving the award. It has really helped to build and strengthen the expertise and credibility of our Talent, Leadership and Organisational Development Centre of Excellence, both within GSK and externally in the L&D profession. Being recognised for the award as an L&D professional has also helped to build my personal profile, credibility and network.
H AV E YO U G O T W H AT I T TA K E S ? V I S I T P FAWA R D S . C O . U K T O F I N D O U T M O R E M AG A ZI N E | S EPT EM B ER 2017 | 3 1
P H A R M ATA L E N T
MOVERS & SHAKERS
Ashfield Commercial and Clinical UK has announced the appointment of David Proffitt as Head of Quality & Compliance in the UK. David has held a number of key roles within Ashfield since joining in 2014, and is transitioning to this role from his prior position as Training Business Manager.
GSK has appointed Karenann Terrell as Chief Digital & Technology Officer with a remit to transform how new technologies are used. Karenann’s previous role was Chief Information Officer for Walmart, where she led a multi-year effort to transform digital engagement with its customers.
Zoetis Inc. has appointed Dr Linda Rhodes to its Board of Directors. Dr Rhodes has extensive experience as a research scientist, academic, veterinary practitioner and business leader, spanning nearly 30 years across the animal health industry.
Pf GR ADUATE OF THE MONTH
WHO’S GOING WHERE AND WHY THEY’RE GOING THERE. WORDS BY
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Here we feature an outstanding newcomer who is making their mark on the industry. NAME: Nadia Hart COMPANY: Working for CHASE on contract to a leading blue-chip Pharmaceutical Company ROLE: Hospital Therapy Specialist Representative, since May 2017 QUALIFICATIONS: Accreditation in Medicines Management (AIMM), Practice Certificate in Pharmacy Management NADIA SAYS: “I started my career in community pharmacy and hospital pharmacy, specialising in medicines management, before becoming Clinical Effectiveness Manager for West Essex CCG. I was looking for a new challenge. Pharma sales really appealed to me because of the chance for career progression. I have now been a Hospital Therapy Specialist for a few months and am pleased I took the leap!”
KNOW A RISING STAR WHO DESERVES A MENTION? RACHEL@PHARMAFIELD.CO.UK
BenevolentAI has announced the appointment of Dr Ian Churcher as Vice President of Drug Discovery & Preclinical Development. He joins from GSK where he headed a discovery performance unit focussed on progressing new approaches, including pioneering the development of protein degradation.
Biogen has announced the appointment of Anabella Villalobos, Ph.D., as Senior Vice President, Biotherapeutic & Medicinal Sciences (BTMS). Dr Villalobos, formerly of Pfizer, will lead Biogen’s BTMS organisation in the delivery of highquality, differentiated molecules.
Brendan Maccaoilte of QuintilesIMS has been promoted to Clinical Sales Specialist - Secondary Care. “Since joining QuintilesIMS I have been supported to further my learning attending courses that have enabled me to be more effective in my call quality, presenting and influencing techniques,” he enthused.
IN BRIEF JODI COATES has been
appointment by G&L Scientific Inc as Vice President of Resource Management. MARK ROTHERA joins
Orchard Therapeutics as CEO. KEITH MCNEIL , Chief KAREN SASSE
BioreclamationIVT has announced the appointment of Karen Sasse to the newly-created position of Vice President of Global Quality and Compliance. She will be responsible for the company’s quality assurance and quality control activities worldwide. “I look forward to facilitating drug discovery and development on a global basis,” she said.
Clinical Information Officer (CCIO) for NHS England, has resigned.
M AG A ZI N E | S EPT EM B ER 2017 | 3 3
P H A R M ATA L E N T
Haseeb Ahmad, Managing Director of Novartis Pharmaceuticals UK & Ireland and Country President Novartis UK, on the secret of his success. INTERVIEW BY
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What do you do? My responsibilities are to manage the day-to-day operations for the Novartis UK pharmaceutical division which delivers life-changing, innovative medicines to patients in the UK and Ireland. I joined the company in February 2017 and I’m proud to be a part of an organisation that has such rich history and heritage, a portfolio of life-changing medicines and an exciting pipeline. How did you get to where you are today? I have been working in the industry for nearly 20 years. Initially, like many, I knew friends in the industry and that played a role in developing my interest. What also drew me to pharmaceuticals, however, was the excitement of working in an industry where you can make valuable changes to people’s lives. I started my career as a sales representative before moving into managerial positions at Schering-Plough and MSD. Having worked in various roles in different countries, I have always tried to listen and learn from those around me, while remaining focused when dealing with challenging situations. What has been instrumental to your success? You need to have drive, purpose and strong values to succeed. I think I have always taken a flexible approach in my different roles, but the one thing that has been consistent throughout my career, whether I was a sales representative in Nottingham or working across the UK, is my basic sense to always ensure patients can gain access to lifechanging medicines. Having that purpose has driven me to succeed. What’s the best piece of careers advice you’ve ever had? My Dad once said to me, ‘If you find a job you love, you’ll never work a day in your life.’ He never pushed me in a particular direction, but he did say to do something that I enjoyed. I’ve been surrounded by medicine all my life and have always been passionate about healthcare. Having this passion for the industry and the desire to change patients’ lives is one of the reasons why I got to where I am today. How is Novartis embracing the growth of digital? The pharmaceutical industry is at a really interesting juncture and, as we are on the cusp of a biopharmaceutical innovation wave, we’re living through a turning point in history. Science is moving at an incredible pace and the introduction of digital technologies is helping to improve
“I’m proud to be a part of an organisation that has such rich history and heritage, a portfolio of life-changing medicines and an exciting pipeline” and transform healthcare. Novartis is exploring ways for digital technology to enhance the delivery of medicines, our customer interactions and how patients engage with their conditions. For example, in recent years Novartis has developed a range of mobile applications to help patients track their disease symptoms over time. They have been launched across many of our disease areas including, psoriasis, multiple sclerosis, urticaria and cancer. What is more important, talent, ambition, or both? Having ambition and working hard for something you believe in is very important. For those of us working in the healthcare industry, we all have the same ambition, which is good patient access to medicine. The drive to succeed is a catalyst to enhance talent. Without ambition, talent alone can just become inert. I feel it is also vital that you work for a company that has a drive to make a valuable contribution to patients as this amplifies individual talent and ambition. How is Novartis preparing for Brexit? Like many companies Novartis is preparing for the UK to leave the EU. Regardless of Brexit, there are a number of issues regarding access to innovative medicines that we would want the government to address. Novartis is keen to work with the Government to ensure that the UK’s relationship with the EU delivers for patients, the NHS and our industry. We want to be able to promote the UK as a place to do good business, and deliver cutting edge medicines to patients. What advice would you give to a person entering the pharma sales industry now? If you like a bit of volatility and unpredictability but, most importantly, you want to do something meaningful for society, then grab the opportunity with both hands. It’s going to be hugely rewarding for those who are motivated to be part of the solution to this global healthcare challenge. Go to novartis.co.uk
Are you a past Pf Award Winner? Our annual Pf Award Winners Club celebration is taking place at the House of Commons on 28 September, 2017. If you’re a Winner but haven’t connected with us yet, go to pfawards.co.uk/ winners-club.html We look forward to seeing you all there! # P FAWA R D S 2 0 1 8
P FAWA R D S .C O.U K
M AG A ZI N E | S EPT EM B ER 2017 | 3 5
O N YOU R R A DA R
BAC K T WE ET THE WORD ON CYBER STREET
M A D E BY: Gilead Vosevi is a daily single-tablet treatment regimen for adults with genotype 1-6 chronic hepatitis C virus. It offers a potential cure and represents the only therapy available for patients who have previously failed with direct-acting antivirals.
S O M E T H I N G TO S AY ? @Pharmafield
Financial Times @FinancialTimes
Faster path for drugs in UK ‘would spur investment and jobs’ BBC Health News @bbchealth
Third of men with poor mental health blame jobs, says Mind ABPI @ABPI_UK
The prospect of truly gamechanging medicines means the outlook for #cancer patients has ‘never looked better’ TerrenceHigginsTrust @THTorguk
Sex and relationships education should cover more than just biology. It should include LGBT relationships, HIV and sexual health. QuintilesIMS @QuintilesIMS
50% of patients had never heard of relevant #clinicaltrials. Can Clinical Trial Educators be the solution? http://bit.ly/2xbxuAA Pf Awards @Pf_Awards
We’re getting excited for the #PfAwards2018 – entries open this month! https://buff.ly/2v3gxtZ Gilead Sciences @GileadSciences
1 in 8 people living with #HIV do not know it. #KnowYourStatus #NHTD http://aidsvu.org/testing Parallel Learning @parallellearn
New models of primary care – what are the options? Are current plans sustainable? Find out more on our next webinar https://buff.ly/2wWkFty Longreads @longreads
Home DNA testing kits are making it easier to learn more about who you are – but they can come with surprising results
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A P P R OV E D M E D I C I N E of the M O N T H
AOB PATIENTS PLEASE
A ‘super group’ of healthcare organisations has insisted the Government protects the interests of patients during Brexit. The Brexit Health Alliance, which combines NHS, research, industry and patient bodies, has warned that patients will suffer unless negotiators ensure that issues such as access to new medicines are given attention. The alliance members includes the Academy of Medical Royal Colleges and NHS Providers.
A new US-developed app, Objective Zero, will anonymously connect ex-military service personnel with veterans who have been trained in suicide-prevention. It also has a range of activities to help people manage PTSD, anxiety and depression, while also providing the option to speak to civilians who have taken a military awareness course. The app is a not-for-profit initiative and will be launched in September 2017.
MIND YOU NHS Employers Chief Executive, Danny Mortimer, has responded to NHS England’s plan to boost mental health services: “The Government and NHS England have rightly prioritised mental health services. This focus on the workforce that provides this care is hugely welcome. Service providers will absolutely play their part in delivering this ambitious plan and will look forward to national support, particularly for improved access to funding and facilitating increased use of international staff.”
SOMETHING THAT SHOULD BE ON OUR R ADAR? R ACHEL@PHARMAFIELD.CO.UK
People on effective HIV treatment CANNOT PASS ON THE VIRUS. FACT. Terrence Higgins Trust is a registered charity in England and Wales (reg no. 288527) and in Scotland (SC039986). Company reg. no. 1778149.
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