Pf Magazine April 2019

Disrupting pharma “In the past, data and clinical care have been separate, but this is a hybrid model” Page 10

APRIL 2019

Open letter to Matt Hancock Inside the NHS Unravelling ABPI PHARMAFIELD.CO.UK

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Hello.

ur cover story this month looks at disruption in pharma and healthcare. Driven by necessity, and fuelled by data, it is a case of disrupt or be disrupted. The industry is evolving, and even without the likes of Amazon and Apple dipping their toes in the water of pharma and health, there is a new dawn coming for the industry.

Also this month, Claudia Rubin has penned an open letter to Health Secretary, Matt Hancock MP. Post Brexit deadline, she asks him to bring his focus back to the NHS, the issues its facing, as well as the impact Brexit has had on science, life sciences, business, preventative medicine and more.

In the first of our Inside NHS columns, Steve How and Paul Midgley of Wilmington Healthcare have mapped out the NHS’s integrated care journey. Exploring how pharma can engage with integrated care systems, they assert that industry must keep abreast of changes in the NHS. We also have an insight into the ABPI and the Prescription Medicines Code of Practice Authority’s role in the code of practice’s administration. Drawing on feedback from industry, Dr Rina Newton documents frustrations and suggested solutions to help industry improve its understanding of the way that the ABPI Code is administered.

The therapy area for this month focuses on multiple sclerosis (MS). Drug options for relapsing remitting MS, the most common form of the condition, have accelerated hugely in the last 15 years. Individuals now have access to 14 different disease modifying drugs for the condition and the MS Trust has developed a tool to help people make informed decisions over their options.

Other topics in this issue of Pf Magazine include falsified medicines, antimicrobial resistance, clinical pharmacists, social media dos and don’ts, understanding healthcare professionals and the Pf Awards 2019.

Thanks for reading this issue. Make sure you visit www.pharmafield.co.uk for daily news updates and exclusive content.

And finally, we’re also delighted to announce that the new PharmaJobs website has launched. Take a look at www.pharmajobs.co.uk to find all the best roles in pharma and healthcare.

HEAD OF CONTENT

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

Amy Schofield amy@pharmafield.co.uk CREATIVE DIRECTOR

Emma Warfield emma@pharmafield.co.uk GRAPHIC DESIGNER

Olivia Cummins olivia@pharmafield.co.uk COMMERCIAL DIRECTOR

Hazel Lodge hazel@pharmafield.co.uk DIGITAL MARKETING EXECUTIVE

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

Hannah Alderton newsdesk@pharmafield.co.uk FINANCIAL CONTROLLER

Fiona Beard finance@e4h.co.uk Pf AWARDS

Melanie Hamer melanie@e4h.co.uk PUBLISHER

Karl Hamer karl@e4h.co.uk HEAD OFFICE

Spirella Building, Bridge Road Letchworth Garden City, Hertfordshire SG6 4ET United Kingdom www.pharmafield.co.uk www.e4h.co.uk ADVERTISING

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M AG A ZI N E | A PR I L 2019 | 1

April HAVE YOUR SAY: If you’d like to share an idea for a feature or collaborate with us on a captivating advertorial, please get in touch.

GET IN TOUCH: hello@pharmafield.co.uk

Contributors

@pharmafield

AMANDA BARRELL

Amanda is a freelance health and medical education journalist, editor and copywriter.

She has worked on projects for pharma, charities and agencies, and has written extensively for patients, healthcare professionals and the general public.

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

@pharmajobsuk

Pf Magazine

PAUL MIDGLEY 

Deborah Evans FRPharmS FFRPS FRSPH is Managing Director of Pharmacy Complete, a training and consultancy company working with pharmacy and the industry.

Paul Midgley is Director of NHS Insight for Wilmington Healthcare’s Consulting Team.

His interest is in NHS and joint industry projects around service integration, particularly in mental health, neurological and other long-term conditions.

He co-chairs Regional Mental Health, Diabetes, Rheumatology, Dermatology and GI Networks across England.

STEVE HOW

DR RINA NEWTON

Steve How is Programme Director for Wilmington Healthcare’s Consulting Team. He has more than 20 years’ experience in healthcare and pharmaceuticals.

He is passionate about partnership and public engagement with the NHS and is Chair of the Citizens’ Council of an ICP.

Dr Rina Newton is Managing Director of CompliMed experts on the ABPI Code. They support any activity that results in better engagement with the ABPI Code, transparency and consistency in PMCPA case rulings and improvements in self-regulation.

DEBORAH EVANS 

RICH QUELCH 

Rich Quelch is an experienced global marketer within the healthcare and pharmaceutical sector. He led the development of the Origin brand, positioning it as a world-leading supplier of innovative pharmaceutical packaging devices.

In this issue CLAUDIA RUBIN 

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

AMY SCHOFIELD 

Amy is Special Editions Editor at Pharmafield. She is an experienced journalist and editor of both digital and print content across healthcare, technology and careers.

HANK SCZERBA

Hank Sczerba is Head of Commercial Strategy and Transformation at Novartis.

ALAN WESTWOOD 

Alan Westwood is Managing Director of Matoke® Pharma, the pharmaceutical division of Matoke® Holdings developing its lead pharmaceutical candidate, RO™101. Alan is an anti-infective strategic specialist and formerly Vice President of Global Strategic Marketing at Bayer.

04 NEWS

22

Bringing you this month’s essential headlines

Going above and beyond FMD in pharma

COVER STORY

10

24

How necessity is driving disruption in pharma and healthcare

PMCPA administration of the ABPI Code

INSIDE THE NHS

13

COFFEE BREAK

Mapping the NHS’s integrated care journey

Proving antibiotics are not always the answer

POLITICS

14

THERAPY AREA

An open letter to Matt Hancock MP

Understanding multiple sclerosis

PHARMACY

16

PF TALENT

The role of pharmacists in GP practices is becoming a reality

Pf Awards 2018 winner, Claire Smith

MARKETING

17

MOVERS & SHAKERS

Understanding healthcare professionals to target them more effectively

Who’s moving where in the industry?

PF AWARDS

18

36

An insight into the Pf Awards 2019 Dinner

Social media dos and don’ts

20 FEATURE

Antimicrobial resistance in the UK

FEATURE

ABPI

26

28 32

34 CAREERS

QUICK DOSES A S TE LL A S P H A R M A has its marketing authorisation application for XOSPATA (gilteritinib) accepted by the European Medicines Agency (EMA).

• O R I O N CO R P O R ATI O N and B AY E R announce that a European marketing authorisation application has been submitted for darolumatide.

• N I C E recommends TA K E DA U K’s ALUNBRIG (brigatinib) for treating ALK-positive advanced non-small-cell lung cancer.

• N A P P P H A R M AC E U TI C A L S launches Pelmeg ®(pegfilgrastim) biosimilar in UK. • S COT TI S H M E D I C I N E S CO N S O RTI U M rejects YESCARTA®.

• Trial for SA N O F I G E N Z Y M E ’s isatuximab meets primary endpoint in patients with myeloma.

• European Commission approves a new indication for P R A LU E NT ®.

• N I C E recommends pertuzumab (Perjeta, Roche) for new breast cancer indication.

• P F I Z E R receives European Commission approval for ZIRABEV ™.

• Scottish Medicines Consortium accepts JA Z Z P H A R M AC E U TI C A L S’ Vyxeos® (daunorubicin and cytarabine) for specific types of high-risk acute myeloid leukaemia.

• NICE supports inclusion in the CANCER DRUGS FUND of daratumumab (Darzalex, Janssen-Cilag) for people with relapsed multiple myeloma.

• European Commission approves R O C H E ’s Tecentriq in combination with Avastin and chemotherapy for a specific type of metastatic lung cancer.

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CANCER

Falling death rates

D

eath rates from breast cancer are predicted to fall in all European Union countries in 2019 with the exception of Poland, according to research published in the cancer journal, Annals of Oncology.

In their annual predictions for cancer deaths in the European Union, Dr Carlo La Vecchia, Professor at the School of Medicine, University of Milan and colleagues predict that in 2019 death rates from breast cancer will fall by almost 9% in the European Union as a whole when compared to 2014.

In Poland however, they will rise by just over 2%.

The researchers warned that although age standardised death rates from breast cancer have fallen from 14.6 per 100,000 of the population in 2014 to a predicted 13.4 per 100,000 in 2019, the actual numbers of deaths from the disease continue to rise due to the increasing numbers of older people.

Breast cancer remains the second highest cancer killer in women after lung cancer.

97%

Pf IN NUMBERS

of Francis Crick Institute scientists believe a hard Brexit would be bad for UK science. Calling Matt Hancock, p14

P f N E W S : B R I N G I N G YO U T H I S M O N T H ' S E S S EN T I A L H E A D L I N E S

NHS

Unhappy people Public satisfaction with the NHS has fallen to its lowest level since 2007, according to analysis of the 2018 British Social Attitudes (BSA) survey published by The King’s Fund and the Nuffield Trust.

The survey, carried out by the National Centre for Social Research (NatCen), is seen as a gold standard measure of public attitudes.

It finds that, following a sharp drop in 2017, public satisfaction with the health service fell to 53%, its lowest level in over a decade. The continued fall in satisfaction came despite Prime Minister Theresa May’s announcement last June – just before the interviews for the survey were undertaken – of a £20bn long-term funding boost for the health service.

The think tanks’ analysis also reveals that public satisfaction with general practice has declined over the past decade. In 2018, it remained at its lowest level since the survey began in 1983 (63%), while dissatisfaction with general practice remained at its highest level since the survey began.

Almost a quarter (24%) of respondents reported being dissatisfied with their GP service.

Antimicrobial resistance is likely to cause another

10 MILLION deaths globally by 2050.

No time to wait, p20

W

omen account for more than three quarters of the NHS workforce in England, according to the NHS Digital statistics published on International Women’s Day. Of the 1,216,719 staff members working in the NHS in September 2018, 935,772 were women (77% of the workforce). The proportion of doctors working in NHS hospitals who are women has grown each year for the last five years from 44% (47,250) in September 2013 to 45% (53,692) in September 2018.

40% of women are ambulance staff, while women also represent 89% of the total nursing and health visitor workforce. Women also make up 83% of roles supporting clinical staff.

The number of women midwives increased from 24,910 in September 2013 to 25,777 in September 2018, however, the number of male midwives fell from 96 in September 2013 to 89 in September 2018.

NHS.

NHS WOMEN

Pf View: These figures show that the NHS is a very female dominated organisation. However, as previous Pf articles have indicated, women are still under-represented in leadership roles. There’s still work to be done.

CANCER

Cancer cash Outcome-based payment (OBP) for cancer drugs based on how well they work in practice could get patients new treatments faster, according to a Cancer Research UK report.

This flexible way of paying for cancer medicine would mean a drug’s price could be adjusted based on how well it works for patients in the NHS. For example, the NHS could pay the company less for a drug that doesn’t work as well as expected, but more if it does.

As well as providing value for money for the NHS, companies whose medicines represent genuine advances would also be rewarded.

Based on feedback from patients and their families about what treatment results are most important to them, the report recommends that when any OBP scheme is introduced it should link the drug’s price to its impact on survival, disease progression or relapse, long-term side effects, and return to normal life.

COLLABORATION

CHECKMATE Bristol-Myers Squibb and Boston Medical Center have announced a multi-year joint research study to identify and analyse potential sensitivity and resistance markers in patients treated with standardof-care checkpoint inhibitors.

The comprehensive, multidimensional study will place an emphasis on uncovering mechanisms associated with lack of response to ImmunoOncology (I-O) therapies, with the ultimate goal of identifying prognostic and potentially predictive I-O biomarkers in a variety of cancers.

M AG A ZI N E | A PR I L 2019 | 5

NICE GUIDANCE

Ear ear Hundreds more people with severe to profound deafness will be eligible for cochlear implants each year, due to updated final guidance from the National Institute for Health and Care Excellence. The update comes after a review of the definition of severe to profound deafness which is used to identify if a cochlear implant might be appropriate.

It’s estimated that currently around 1260 people in England receive cochlear implants each year. These updated recommendations could lead to a 70% increase in that number, to 2150 people, once a steady state is reached in 2024/25.

The annual cost associated with implementing this guidance is anticipated to be around £5.5m, £17.3m, £28.6m, £39.8m and £50.8m for years one to five. From year 6 (2024/25) onwards, the annual cost is around £30m.

Implementation of the new recommendations would meet the budget impact test in year three, however, NHS England has decided not to engage in commercial discussions with the companies.

As such commissioners have three months from the announcement to implement these recommendations.

The total cost of a cochlear implant for one ear including the surgery is £22,919 and for two ears is £37,904.

TECH.

MOLECULE MARKETPLACE

L

inum Labs, a software development studio that builds blockchain-based solutions, has announced the launch of Molecule, a software platform and marketplace to accelerate innovation in the pharmaceutical and biotechnology industry.

Molecule connects scientists, patients and industry to advance drug development in a collaborative open market. By creating an open market for participants to crowdfund and discover promising therapeutics, it aims to solve core issues in the industry’s current business and innovation model.

Swiss-based Linum Labs AG began developing Molecule in early 2018 and intends to build out the platform as an open source industry initiative on behalf of the Molecule Foundation, a Swiss non-profit.

The next phase of development will include testing with an early user cohort and further iterations of the initial prototype, leading into a minimum viable product. This will be supported by a financing round due to start in Q2 2019.

Pf IN NUMBERS

77% 53% of NHS workforce are women

PUBLIC SATISFACTION

with the NHS has fallen to

High-tech medical devices make up less than 10% of all healthcare M&A Disrupting pharma, p10

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P f N E W S : B R I N G I N G YO U T H I S M O N T H ' S E S S EN T I A L H E A D L I N E S

A

HIV

HIV breakthrough A case, published in Nature and carried out by scientists at University College London, Imperial College London, the University of Cambridge and the University of Oxford, has reported that HIV remission has been achieved in a second patient.

This is the second person to experience sustained remission from HIV-1 after ceasing treatment, and comes 10 years after the first such case, known as the ‘Berlin Patient’.

The research was funded by the MRC, Wellcome, the Foundation for AIDS Research, and National Institute for Health Research (NIHR) Biomedical Research Centres at University College London Hospitals, Oxford, Cambridge and Imperial.

Both patients thus far were treated with stem cell transplants from donors carrying a genetic mutation that prevents expression of an HIV receptor CCR5.

The subject of the new study has been in remission for 18 months after his antiretroviral therapy was discontinued. The authors say it is too early to say with certainty that he has been cured of HIV and will continue to monitor his condition.

Pf View: To hear of a second person to be in remission from HIV after stopping treatment just highlights the incredible developments in HIV therapy in the last 30 years.

NHS.

DIGITAL AGE

new joint unit, NHSX, will be created to bring the benefits of modern technology to every patient and clinician.

It will combine the best talent from government, the NHS and industry.

NHSX will aim to create the most advanced health and care service in the world to diagnose diseases earlier, free up staff time and empower patients to take greater control of their own healthcare.

Currently, much NHS technology relies on systems designed for a preinternet age. Patients are not getting the care they need because their data does not follow them round the system.

Change has been slow because responsibility for digital, data and technology has been split across multiple agencies, teams and organisations. NHSX will change this by bringing together all the levers of policy, implementation andchange for the first time.

NHSX will work with the NHS and the wider digital economy to build world-class digital services to improve patient care and enable medical research.

PHARMA

TELL US MORE The National Institute for Health and Care Excellence (NICE) has requested further evidence on blinatumomab for the treatment of adults with acute lymphoblastic leukaemia.

The committee concluded that blinatumomab has significant clinical benefits but that further evidence on cost-effectiveness is required to assess its plausibility for NHS funding. NICE has requested further clarification from the manufacturer, Amgen, for the second committee meeting in April.

Blinatumomab, also known as Blincyto, is licensed for treating adults with Philadelphia chromosome-negative CD19 positive B‑precursor acute lymphoblastic leukaemia. It is for people in first or second complete remission with minimal residual disease greater than or equal to 0.1%.

Blinatumomab is administered intravenously and has a list price of £2,017 per 38.5 microgram vial. The average cost of blinatumomab for each treatment cycle at the list price is £56,476.

M AG A ZI N E | A PR I L 2019 | 7

A

major new survey commissioned by the Royal Society of Chemistry (RSC) has revealed the full extent of the sector’s concerns over a No Deal Brexit.

The RSC questioned 5800 chemistry professionals from across the UK, EU and beyond, with the results demonstrating that the change would be potentially catastrophic for science and innovation in the UK. Chemistry is worth £50bn to the UK economy, but a Bank of England report last year said that in the event of No Deal the sector’s output would drop by 35% – the equivalent of a £17.5bn loss to the economy, making it one of the sectors hardest hit by a No Deal scenario.

Key concerns raised by survey respondents, including those based in the UK, were around: • access to international facilities and collaborative networks • funding for fundamental, curiosity-driven research • access to large-scale grants • easy movement for skilled scientists.

Further concerns uncovered by the survey include the impact that a new visa requirement would have on attracting talent to the UK for science and innovation, with 71% saying there would be a negative impact.

DIGITAL HEALTH

Appy women

Quin, a company owned by women, is expanding its research and development of a pioneering Type 1 diabetes management app for people who are living with the condition, which requires individuals to self-administer insulin throughout the day to ensure HbA1c (average blood glucose level over three months) is as close to normal as possible.

Of the 3.8 million people who are currently living with diabetes in the UK, approximately 300,000 people are diagnosed with Type 1 Diabetes Mellitus (T1DM). As the molecular taxonomy for diabetes remains incomplete, current guidelines can only provide generic solutions as the factors that affect blood glucose are not fully understood. As a result, only 8% of this population achieve HbA1c targets with current diabetes management tools and devices.

People who take insulin are two to three times more likely to have fatigue, anxiety, stress and depression, due to the demands of diabetes. The Quin mobile medical app is taking an alternative approach to T1DM management. Using an artificial intelligence-powered algorithm, the app aims to help relieve the cognitive and psychological load of decision-making by tracking what may be affecting an individual’s blood glucose, and recalling what’s worked for them in the past to help them make the best possible self-care decisions.

The app is currently in a beta version that is being built in collaboration with users as a part of a Research Testing Programme.

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

BREXIT.

DEAL OR NO DEAL

Pf View: Hearing of the impact that a No Deal Brexit could have on the chemistry industry just reinforces concerns that are being echoed across many industries. Funding, skills shortages, and workforce issues will all have an impact.

COMPANY RESULTS CLINICAL TRIALS

Ease in Amryt has announced an update on its pivotal Phase III EASE trial for AP101 as a potential treatment for Epidermolysis Bullosa (EB).

Following an assessment by the trial’s Independent Data Monitoring Committee (IDMC), the Company can now enrol infants and children with EB between the ages of 21 days to four years into the trial. The IDMC’s analysis was conducted using pharmacokinetic data received from patients already enrolled in the trial (aged four years and older). This follows the announcement of the unblinded interim efficacy analysis in January.

Amryt will begin the recruitment process for infants and children into EASE immediately. The EASE trial is the largest ever global Phase III study conducted in patients with EB and Amryt expects top-line data read out in H2 2019.

GSK IN NUMBERS GSK’s 2018 results have been announced along with a statement that the rebuild of its pharmaceuticals pipeline continues with 33 of the 46 new medicines now in development targeting modulation of the immune system.

Headline figures include: • Group sales: £30.8 billion • Pharmaceuticals sales: £17.3 billion • Vaccines sales: £5.9 billion • Consumer healthcare sales: £7.7 billion • Total new respiratory product sales: £2.6 billion • Total HIV sales: £4.7 billion.

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T

PHARMA.

ICYMI

IN COMPETITION

IN CASE YOU MISSED IT

I NTE G R AT E D C A R E UNDERPINS NEW NHS PLAN

P M S O C I E T Y AWA R D S WINNERS

Steve How and Oli Hudson, of the Wilmington Healthcare Consulting Team, explore how joined-up, holistic thinking is key to the NHS Long Term Plan.

The highly-anticipated Plan provides a blueprint for the design and delivery of NHS services over the coming decade and puts integrated care systems at the heart of its strategy.

Key aspirations aligned with this joined- up style of thinking include boosting out-of-hospital care and “dissolving the historic divide between primary and community health services”.

The 33rd annual PM Society Awards winners were announced at Grosvenor House on 1 February.

Gold winners included the Havas Lynx Group with 10 Awards, CDM London, Envision Pharma Group, Life Healthcare, McCann Health, Ogilvy, woolley pau gyro and Wordbird.

Sanofi Genzyme and Regeneron won five Gold Awards and one Silver.

AstraZeneca won two Golds, and other Gold winners included Aspen, Boeringher Ingelheim, Galderma, Johnson & Johnson, Mundipharma, Napp, Novartis, PTC Therapeutics, Shire, Teva, Tillotts Pharma and ViiV. The ceremony was hosted by Rob Beckett together with comedian Tom Allen and Alan Dedicoat.

There were 27 different agencies that received a Gold, Silver or Bronze for their work with 34 different pharmaceutical companies.

The PM Society Awards recognise creativity, impact and innovation across pharmaceutical and healthcare advertising and communications.

Read the full list of Gold Awards Winners on the Pf website.

G O I N G PA P E R L E S S I N H E A LT H C A R E

MORE THAN JUST PRINT. Each month we publish daily news and exclusive articles on www.pharmafield.co.uk.

Here’s a look at some of the exclusive content you may have missed.

he European Commission has published a report showing that active competition law enforcement, at EU and national level, in the pharmaceutical sector contributes to delivering more affordable medicines and more choice to patients and healthcare systems; as well as promoting further innovation.

The report provides an overview on the enforcement of antitrust and merger rules in the pharmaceutical sector and describes how competition law enforcement has contributed to improving European patients’ access to affordable and innovative essential medicines. It focuses on the period since 2009, when the Commission carried out an inquiry into competition in the pharmaceutical sector.

Besides environmental factors and a desire for a more sustainable business model, paperless workplaces encourage better data protection, reduce resource output, and add benefits to workflow and file management. If that isn’t enough, the NHS’s ambitious plan to go paperless by 2020, as well as its recent decision to ban all new acquisitions of fax machines, could leave healthcare organisations that operate outdated document platforms on the back foot. The eFax Team share their step-bystep guide to going paperless in healthcare.

 Want to know the full stories? Find these & the latest news at www.pharmafield.co.uk

M AG A ZI N E | A PR I L 2019 | 9

Disrupting pharma NECESSITY IS THE MOTHER OF INNOVATION

WORDS BY

Amanda Barrell 10 | P H A R M A FI EL D.CO.U K

C OV ER S TO RY

In a data-driven future of efficient, personalised healthcare, the only limitations will be the intelligence of our ideas and our ability to take the public with us.

A

“perfect storm” of system crisis and technological advances has created a flurry of innovation, and knowledge from other sectors is promising to create smarter, more efficient ways to provide healthcare.

But the potential new dawn of personalised, remote medicine and all the associated improvements in outcomes is heavily reliant on data – and the sector proving it is responsible enough to crunch it.

Dr Stuart Battersby, Chief Technology Officer at Chatterbox Labs, says that harnessing data and new technologies presents industry with challenges: “New technologies, particularly artificial intelligence, really have the potential to unlock valuable insights that can improve patient care and accelerate outcomes.

“However, this data is sensitive and highly confidential. This often means it’s challenging for organisations to really get their teeth into using these new technologies.”

UK AS INNOVATION HQ

Hassan Chaudhury, Director and Co-founder at HealthIQ, is also a medical technology (med tech) specialist for the Department of International Trade so has a front-row seat for observing the country’s challenges to and opportunities for innovation.

He says that the UK is leading the way in many areas of med tech, including genomics and artificial intelligence, because of its need to drive efficiency and its unique access to an information gold mine.

“While the NHS is not commercial, our priorities mean we have to think as though we were.

If we had a bloated, lazy healthcare system, we wouldn’t be trying to do things better, but we really need to think about how we make the best of our resources.

“We have cradle-to-grave, longitudinal data. No country in the world can do what we can do with that data,” he said.

Organisations have been collecting data for years, but as disruption in healthcare depends on the ability to safely repurpose knowledge from other sectors, it has tended to lag behind.

PARADIGM SHIFT

OPERATIONAL EFFICIENCIES

The paradigm is shifting, however, as non-healthcare businesses, including big names such as Amazon, Google and Samsung, move into the space.

A recently published mergers and acquisitions (M&A) report from technology M&A advisory firm Hampleton Partners painted a picture of a busy and buoyant marketplace.

Jonathan Simnett, a Director with the firm, told Pharmafield: “The one thing that really stood out was the rapid rate of change in healthcare systems. M&A is the new R&D. Companies can’t innovate quick enough, so they have to go and buy companies that have spotted new areas to innovate in.

“Everyone is piling into healthcare.

Amazon has bought PillPack. Apple is investing heavily and has said that healthcare will be its major market going forward.”

The push is being driven by the fact that companies understand that they have the knowledge and ability to solve some of the biggest problems facing healthcare systems globally.

“Healthcare systems, certainly in the developing world, are struggling to cope with the same issues: ageing populations, a rise in lifestyle conditions, and increasing patient expectations,” explained Jonathan.

“All of these come together to produce spiralling costs, and the costs of healthcare are running ahead of anything else in the economy.

People are looking to technology to reduce costs and bring efficiencies into healthcare.”

It’s not just the ‘sexy’ stuff like virtual reality and robotic prosthetics that are paving the way for the future – in fact, it’s quite the opposite, continued Jonathan.

He said: “People think of health tech as a new sexy device, but the reality is that high-tech medical devices make up less than 10% of all the M&A that’s going on in healthcare.”

Around half of all the disclosed money being spent in this area is on vertical software for tasks such as hospital management, patient analytics and pharmaceutical discovery, for example.

“That is the relatively prosaic sort of thing that’s going on in any business to improve the processes needed to better deliver the mission, which is, in this case, well people.

“It’s indivisible from rising costs. It’s a perfect storm. The NHS, and any other healthcare system, is trying to deal with an impossible set of demands.”

Around a quarter of the market, he went on, was IT services, which has been driven by the rise of the Software as a Service (SaaS) model. The provision of electronic health records and ‘self-service care’ applications were also in the mix.

All of these areas are quietly revolutionising the nuts and bolts of how healthcare is delivered efficiently, while detailed, data-driven consumer knowledge is being used to develop ever better personalised care.

M AG A ZI N E | A P R I L 2019 | 11

COVER S TO RY

Without data the dream of machine learning and artificial intelligence transforming our healthcare system will fail at the first hurdle

PUBLIC TRANSFORMATION

AUGMENTED HUMANITY

Transformative ideas are not limited to the private sector, however, as shown by the NHS Genomic Medicine Service, which will be rolled out this summer.

Building on The 100,000 Genomes Project, it will provide healthcare professionals with a directory of available genetic tests and access to seven new genomic ‘hubs’.

Crucially, patients who have their DNA sequenced will also be asked to consent to being re-contacted when relevant research gets underway.

Dr Gemma Chandratillake, Education and Training Lead at the East of England NHS Genomic Medicine Centre, said the programme demonstrated the transformative potential of structured, integrated data collection.

“In the past, research and clinical care have been separate, but this is a hybrid model. It changes the dynamic, makes research a two-way street and gives researchers access to readyassembled cohorts,” she explained.

There’s also scope in pharmacogenetics and pharmacogenetic testing, she added, highlighting how this could spark greater advances in personalised medicine.

“We all know that people do not react to drugs in the same way, partly because of the way different people metabolise them. You could look for genetic markers of enzymes related to metabolism and that would make a big difference in terms of drug choice and dosage,” Gemma added.

This kind of data amalgamation offers the possibility of “plugging gaps” in the healthcare system, said Hassan, who is also a Researcher at Imperial College London.

“It’s about leveraging the data to find where the problems are, then, if it’s a routine task, finding ways to make it automated.

“We have a shortage of radiologists, for example. So, if there is a way you feed the scans into a machine that can knock out the 80% they do not need to worry about, they could focus on the 20% that do need their attention.

“It’s not about replacing the human, it’s about augmenting the human.”

Such ideas could be transformative in terms of treatment, outcomes and costs, and the time is ripe to start delivering on these promises.

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ACCELERATING PROGRESS

INFORMED CONSENT

If the innovation is happening across pharma, healthcare and technology and momentum is building, it’s now time to accelerate the progress. Stuart said: “Technology and statistics are not new to pharma, the industry is built on both.

I think here the opportunity really is that technology, in particular machine learning and artificial intelligence, has the potential to hugely accelerate time to results.”

Key to fulfilling this potential is partnership, both between the private and public sectors and between healthcare systems and patients.

“The labour market for PhD-educated artificial intelligence scientists is constrained, however what pharma and healthcare both have are excellent subject matter experts who understand both their data and their real-world problems,” Stuart added.

“What we believe they need is tooling that is able to strike the balance between empowering them to interrogate their data whilst not bogging them down with the details of the underlying machine learning.”

The most important thing, everyone agreed, was to engage the public in this process of change.

“People value the NHS and they want to help. They want cures for cancer and treatments for rare diseases,” said Gemma, adding that transparency and engagement were the keys to gaining consent.

Hassan pointed to the Wellcome Trust’s Understanding Patient Data initiative. Billed as a vehicle to support the public’s understanding of what health data is, how it is protected and its life-changing potential, he said the programme needed the industry’s support.

“There is suspicion around data collection, so there needs to be public outreach from every major company. We all need to come together in a common voice.”

Humanisation and coordination are vital, he added, because without data the dream of machine learning and artificial intelligence transforming our healthcare system will fail at the first hurdle.

INSIDE THE NHS

Integrated care Steve How and Paul Midgley, of Wilmington Healthcare, track the progress of NHS England’s diverse local health economies in delivering integrated care.

WORDS BY

Steve How and Paul Midgley

T

he recently published NHS Long Term Plan states that,

by April 2021, all areas of England will be covered by an Integrated Care System (ICS), with typically one clinical commissioning group (CCG) per ICS area.

Currently, however, there is huge variance in the way that local health systems are being run across England, with some areas leading the way in ICSs; while others are in financial recovery and at the start of their integrated care journey.

Even within the first wave of 14 ICSs, there are different levels of sophistication, with a handful of the most advanced systems having dispensed with standard Payment by Results (PBR) contracts and operating more integrated budgets.

These highly advanced ICSs are the beacons of excellence which all other health systems are under pressure to emulate within the next few years.

Mapping regional variants around integrated care, understanding how the needs of local health systems differ and keeping abreast of change over the next few years, will be of paramount importance for the pharmaceutical industry.

For Sustainability and Transformation Partnership (STP) customers that will become ICSs in the next couple of years, pharma needs to identify the clinical leaders tasked with making it happen. Although industry needs to be mindful that reducing direct costs will still be a priority for these organisations, reducing system costs across the whole pathway is the driver for change.

Most ICSs are at the point where they are preparing to deliver fully integrated holistic care and for these customers pharma needs to identify where transformation is occurring and define how that aligns with its own workstreams and wider ICS priorities, such as frailty.

When engaging with the very small number of highly advanced ICSs that already have fully integrated budgets, pharma should consider instigating top level discussions involving its chief executive or managing director to define the wider value that the company can deliver. Such discussions should be held in addition to deploying sales staff to engage at clinician level on products and how they fit into care pathways.

The individual plans that local health systems must prepare for NHS England in response to the Long Term Plan will provide useful insights for pharma and information about them should be found in draft board meeting minutes published in March.

A number of documents, such as the primary care network contract, have also recently been published by the NHS which detail how certain aspects of the Long Term Plan will be delivered. Pharma must keep abreast of these changes and ensure that its engagement strategy is tailored to support the diverse needs of individual health economies.

Steve How and Paul Midgley are part of Wilmington Healthcare’s Consulting Team.

For information on Wilmington Healthcare, go to www.wilmingtonhealthcare.com

Translating the changing NHS to help you deliver your solutions where your customers need them most.

Visit our website at wilmingtonhealthcare.com /knowledge-hub

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For further information or to find out how we may be able to help you, contact: info@wilmingtonhealthcare.com or call 01268 495600

For more information on pharma, the NHS Long Term Plan and integration, search ‘Integrated care underpins new NHS plan’ on the Pharmafield website.

M AG A ZI N E | A P R I L 2019 | 13

CALLING

MATT HANCOCK MP Claudia Rubin pens an open letter to Matt Hancock MP urging him to celebrate science and support its central and complex role in shaping health policy.

DEAR SECRETARY OF STATE,

W

time, claimed that the British people had had enough of experts.

The CBI cautioned repeatedly, and to no avail, that your government’s

HAT A SHAMBLES.

handling of Brexit was harming their members’ businesses. The

Brexit-day, 29 March, has been

Association of the British Pharmaceutical Industry has been vocal

and gone and though Britain may

too, warning recently that the UK is in danger of losing its world-

not have literally fallen off a cliff

leading research and development status owing to Brexit fallout.

or the economy crashed entirely, Brexit has changed irrevocably

Scientists could not have been clearer. A survey of over 1000 staff at the Francis Crick Institute, the UK’s biggest biomedical research

the landscape of UK politics in many ways. Great leadership must

laboratory, revealed that 97% of scientists there believed a hard

now be shown to reset relationships, re-state our priorities and define

Brexit would be bad for UK science.

where we are to go from here.

Certainly, we have let problems grow by being distracted from

Given the hard, anti-science, anti-business Brexit path pursued by the Conservative Government, it is important to reflect on the

any domestic agenda by Brexit. You know all too well the troubles

impression this leaves, of the subversion of rigour, science and

that the NHS finds itself in after a decade of austerity compounded

expertise, and how it may pervade into society at every level.

by Brexit. Official NHS statistics show waits at A&E departments

You will recall Sir Paul Nurse, in his role as past Chair of the

in England have hit their worst levels since records began. Public

Royal Society, warning in response to Mr Gove that: “The fact

satisfaction with the NHS has fallen to its lowest level since 2007,

that experts have been derided in this way does have an effect

according to analysis of the 2018 British Social Attitudes survey,

in undermining science and scientific evidence”.

published recently by The King’s Fund and the Nuffield Trust.

But one of the more pernicious effects of Brexit is perhaps the subversion of science, the rejection of evidence, and the

Like a pebble hitting the water, the repercussions of the ‘abuse’ of science and scientists in recent years will be felt across healthcare.

Take one of your key priorities for example, prevention medicine.

de-prioritisation of UK industry as a key driver of decision-making.

This area of medicine is heavily reliant on public trust in the science of

For had the opinions of scientists, economists and the industries

screening and policies supporting it, but the signs here are not good.

– of manufacturing, pharmaceutical and many others – been truly

The NHS screening programme has reported the lowest levels for

valued, we would never have found ourselves at this precipice.

over a decade of women taking up breast screening. Last year, only

It was indeed one of the most memorable exchanges of the

70.5% of eligible women responded to a breast screening invitation,

Brexit campaign when Michael Gove MP, Justice Secretary at the

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meaning more than 750,000 women went unchecked.

POLITICS

WORDS BY

Claudia Rubin

“THE REPERCUSSIONS OF THE ‘ABUSE’ OF SCIENCE A ND SCIENTISTS IN RECENT YEARS WILL BE FELT ACROSS HEALTHCARE”

Public Health England is currently running a cervical screening

your predecessor in May 2018, could be a helpful guide as to the

awareness campaign to address the 20-year low point in take-up

efforts being taken to repair scientific standing in the UK. What

by women, which in some areas is down to 50%.

might we expect from this group under your leadership?

The vaccine programme too, is at risk from good science giving way

This year, the new voluntary pricing agreement has come into force.

to myth and rumour. The MMR vaccine rate has fallen again in 2017-18,

It commits the Government and the NHS to work together with

with coverage now at 91.2% in England, (the World Health Organization

industry to support innovation, so that people across the UK will

target is 95%) and with London at the lowest rate, at 85.1%.

see better and faster access to the most effective new medicines and

You have stated that you do not want to give any “credence” to

vaccines. Are you confident in the ability of existing mechanisms

the “anti-vaxxers”, who spread junk science about immunisation,

to support this? What role will you play, for example, in the oversight

and this is welcome, but will you go further? Debunking vaccine

of the methodologies review at the National Institute for Health and

myths is important – Simon Stevens recently announced that

Care Excellence into its health technology appraisal process?

NHS England is considering what action it could take to help stop

Without meaningful change in process, as well as in tone and

the spread of anti-vaccine messages. This might benefit from an

culture, scientists and those around them who seek to translate

injection of some urgency from your office.

their discoveries into real-life healthcare advances, will continue

When and how will you articulate the vital and highly-complex role of science in underpinning all healthcare decision-making

to wonder about their long-term UK prospects and the conceptual damage caused by Brexit may yet be underestimated.

processes? What steps might you take this year to see that this is put into practice, in order to regain some of the enormous ground lost over the past three years?

Last year, you penned the foreword to the second Life Sciences Sector Deal, aimed at deepening the Government’s partnership with industry, universities and charities, and demonstrating how the NHS is pivotal as a delivery partner. We now need to see commitment, drive and determination from you and every level of your leadership team, for its delivery.

Progess made by the Life Sciences Council, the inaugural meeting of which was held at Downing Street and co-chaired by

M AG A ZI N E | A P R I L 2019 | 15

PHARMACY

Pharmacy GP

reality The role of clinical pharmacists in primary and community care WORDS BY Deborah Evans

T

he General Practitioners Committee of the British Medical Association’s longstanding ambition for every GP practice to benefit from having a pharmacist is now much closer with the launch of the NHS Long Term Plan and new GP contract. Both firmly embed the role of clinical pharmacists in primary and community care, and specifically within the new primary care networks (PCNs).

The plan goes far beyond the current goal of 2000 clinical pharmacists and outlines how a typical PCN of 50,000 patients will be able to choose to have its own team of around six full-time equivalent clinical pharmacists by 2023/24, depending on local context.

The new clinical pharmacist roles will be part of a multidisciplinary team (MDT) operating at PCN level, supervised by a senior pharmacist and seeing patients wherever is most appropriate. This could include in a patient’s own home, a care home, a GP surgery or other community venue, including community pharmacy.

These new roles will be funded through a new Additional Roles Reimbursement Scheme which will meet a recurrent 70% of the costs for additional clinical pharmacists.

ROLES AND RESPONSIBILITIES

These dedicated clinical pharmacy teams will allow the development of varied and tailored roles which will include undertaking structured medication reviews, improving medicines optimisation and safety, supporting care homes, and running practice clinics. Pharmacists will play a key role in supporting delivery of the Directed Enhanced Service (DES) specifications within the new networks and this will include tackling over-medication of patients, inappropriate prescribing of antibiotics and withdrawing medicines no longer needed. Pharmacist reviews are expected to reduce avoidable A&E attendances, hospital admissions, avoidable outpatient visits and over-medication.

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Clinical pharmacists will be working in a consistent way across the country and all must complete an 18-month training programme to enhance clinical knowledge and skills, leadership skills and qualify as independent prescribers. The key role responsibilities for clinical pharmacists include: • Clinical assessment and treatment of patients using their expert knowledge of medicines • Care management of patients with chronic diseases • Clinical medication reviews to proactively manage people with complex polypharmacy, especially older people, people in care homes, people with multiple long-term conditions (in particular chronic obstructive pulmonary disease and asthma) and people with learning difficulties • Reducing waste and promoting self-care through structured medication reviews • Working with, and alongside, the MDT in a PCN as prescribers • Providing specialist expertise in the use of medicines • Leadership on person-centred medicines optimisation, quality improvement and support further integration of general practice with the wider healthcare team • Taking a central role in the clinical aspects of shared care protocols and clinical research • Working with specialist pharmacists in hospitals and liaising with community pharmacies.

SIGNIFICANT SHIFT

Shortly after I qualified 30 years ago, pharmacists in hospitals began their journey to establish the invaluable leadership role in medicines they have alongside other clinicians. These announcements signal another significant shift for the profession, this time within primary care. The NHS is already making better use of the clinical skills of pharmacy professionals and, with leadership from experienced and senior strategic NHS pharmacy leaders in the integrated care systems, the full integration of pharmacy practice will become a reality. Patients and the NHS can only benefit. Deborah Evans FRPharmS FFRPS FRSPH is Managing Director of Pharmacy Complete, a training and consultancy company working with pharmacy and the industry. Go to www.pharmacycomplete.org

MARKETING

Hank Sczerba on how to understand healthcare professionals in order to target them more effectively

INTERVIEW BY

Emma Morriss

ON TARGET

T

ell me about yourself and what you do? I am Head of Commercial Excellence and Salesforce Effectiveness for Novartis in Austria.

We’re talking about how to gain a deeper understanding of healthcare professionals (HCPs) to target them more effectively, what advice would you give? With digital it is easy to collect information: you have data from online training or newsletter usage and there are publishing houses who sell their insights and data. All this will help you to get deep insights and do proper segmentation.

What’s the most effective way to engage HCPs? There is no one-size-fits-all approach.

My experience is for instance geographically – in the countryside people are less digitally connected, in the city they are more so.

How can you understand the behaviours, motivations and attitudes of the HCPs you want to access? There are some consistent findings around age groups and digital usage. GPs have traditionally been early adopters of digital channels.

There also appears to be less of an age group difference amongst doctors.

How can you track the effectiveness of different approaches? Digital effectiveness data is easy to gather – however, all other data can be difficult.

For example, prescribing behaviour can’t be tracked. Data can be collected at pharmacy level, but it’s not as pinpointed as to identify an individual doctor’s prescribing behaviour.

Are HCPs moving more towards digital or is there still a place for traditional channels? Digital will be an easier route to access healthcare professionals.

However, I believe that there’s still a place for traditional approaches in the marketing mix. There’s still a place for the representative, however, the top role has to change and be more interactive.

What are the benefits of doing that?

Doctors are very busy, making digital an easy route to engage. They can do it at a time that suits them; it’s more convenient.

Also, digital is cheaper than traditional marketing methods. If doctors opt-in to receive digital communications, you can save on the costs of printed materials.

What’s the best piece of advice you’d give to pharma professionals regarding engaging their customers? All of this is very dependent on the right customer insights to understand the best route to engage each individual. If you start there you will get it right.

Is there anything else you’d like to share?

The industry needs to look at how we use digital in daily life and apply that to practice. It’s a definite mindset change.

For example, people rarely transfer money via cheque anymore, so why does the health service expect doctors to prescribe on paper? It’s time to update, revolutionise and disrupt.

M AG A ZI N E | A P R I L 2019 | 17

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SPONSORS

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PAYER ENGAGEMENT AWARD Sponsored by MSD

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Raheel Mirza and Kay Varlas, Thornton & Ross Ltd

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EXPERIENCED ACCOUNT MANAGER AWARD

Emma Reynolds, Roche Products Ltd and James Perry, AbbVie Ltd

Tom Marlow, LEO Pharma

CROSS-FUNCTIONAL TEAM AWARD Sponsored by Ashfield

Sponsored by Mylan

FUTURE LEADERS AWARD Sponsored by IQVIA

Jack Worts, MSD and Lorna Towndrow, Ashfield

COMMERCIAL IMPACT AWARD Sponsored by Alveo Solutions

Richard Jarvis and Mudeer Khwaja, Novartis

JOINT WORKING AWARD Sponsored by Bayer

Neil MacDonald, MSD

FIELD MANAGER AWARD Sponsored by LEO Pharma

Katrina Lyons and Sue Foster, LEO Pharma

Dave Lampard, Thornton & Ross Ltd NURSE ADVISOR AWARD Sponsored by Novartis

NEW ACCOUNT MANAGER AWARD

Tracey Hart, Coloplast

Sponsored by Republic M! UK LTD

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E-REPRESENTATIVE AWARD

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MEDICAL SCIENTIFIC LIAISON AWARD

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OUTSTANDING PERFORMER AWARD

PRIMARY CARE SPECIALIST AWARD

Jack Worts, MSD and Lorna Towndrow, Ashfield

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Post Awards Brochure Full coverage of the Pf Awards 2019 will be published in Pf’s official Post Awards Brochure, out in May. For hard copies, subscribe at W W W. PH A R M A FI E LD.CO.U K / S U B SC R I B E Do you have what it takes to be a Pf Awards Winner? Enter Pf Awards 2020, the 20th Anniversary of Pf Awards, and compete against the best in the industry.

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NO TIME TO WAIT Antimicrobial resistance in the UK: The need, the challenge & the way forward

T

he Government wants the UK to become a leader in the development of products which tackle the global challenge of antimicrobial resistance (AMR). Despite the renewal of the 5-year AMR Strategy, there is no time to wait before driving new antimicrobial innovations into the mainstream. There must be leadership from the pharmaceutical industry to bolster support for smaller biotechnology firms to overcome the challenges that they face.

MEDICAL NEED & INNOVATION

Around 5000 of the 700,000 global deaths attributed to AMR every year occur in the UK. Without urgent action, AMR is likely to cause another 10 million deaths globally by 2050, according to the World Health Organization.

With large pharmaceutical companies halting investment in early stage antibiotic R&D, it has fallen to SMEs to fill the pipeline. Yet these companies face challenges such as sparse access to funding opportunities, protecting ownership of intellectual property and a challenging regulatory landscape.

Despite these obstacles, some SMEs are discovering novel antimicrobials, exploring new delivery

2 0 | P H A R M A FI EL D.CO.U K

mechanisms and thinking about solutions in different ways to offer more than conventional antibiotics.

These innovations are tackling huge health problems, including chronic non-healing wounds and their associated biofilms.

The development of new products is a sign that progress can be made.

However, if the UK’s antimicrobial sector is to flourish, as the Government hopes it can, there is a need for renewed investment from both industry and Government.

THE CHALLENGE FOR THE PHARMACEUTICAL INDUSTRY

If antibiotics are overused, bacteria can become resistant to them, so the Government is trying to reduce their use. The pharmaceutical industry has found itself in a cycle where antibiotics are repeatedly nullified but are not being sufficiently replaced. There have been no new antibiotic classes brought to market since the 1990s, nor any significant recent advances – there have been several introductions to market but few that are commercially viable.

The cost is too high; the reward too little. Pharmaceutical companies struggle to justify spending in an area where the Government is pushing to reduce antibiotic use. Innovative new therapies that are suitably reimbursed may offer a way out of this problem.

THE GOVERNMENT’S STRATEGY:

Two steps forward…

The recent renewal of the UK Government’s 5-year AMR Strategy could not come at a more pressing time. As Dame Sally Davies, Chief Medical Officer of the UK and global AMR champion, steps down, the UK must further its commitment to be a global leader in AMR, or risk missing its moment.

Two key announcements in the Strategy have shown that the UK is serious about AMR: 1. The commitment to trial a valuebased pricing system to overcome market failure for antibiotics.

2. The commitment to make AMR a priority for the Accelerated Access Pathway, the hugely promising fast-track programme for bringing medical innovations to market.

In addition, however, the Government should aim to oil the industry machine, kickstarting the process of bringing innovations to market. This includes making processes as streamlined as possible for SMEs by: Simplifying the cumbersome grant and funding application processes Providing greater protection to SMEs’ intellectual property Offering greater support to help bring treatments to market, eg clearer guidance and streamlining the regulatory process.

The Government’s Strategy is an early and positive indication of what the future might hold, but considerable work is needed to move forward.

F E AT U R E

It is time for all of us to come together to find a solution that works WORDS BY Alan Westwood

THE UK AS A GLOBAL LEADER

A FAILURE TO ADDRESS THE PROBLEM OF ANTIBIOTIC RESISTANCE GLOBALLY COULD RESULT IN:

10 million deaths by 2050 A global cost of £66 trillion

Source: Public Health England Guidance – Health Matters: Antimicrobial Resistance

The UK has always had a global outlook when it comes to AMR. The focus has been not just to control in-country challenges, but to consider how it can impact developments on the world stage. This will continue and the biotechnology sector is wellplaced to demonstrate leadership in the years ahead.

For this to happen, the pharmaceutical and biotechnology industry must be bold and aggressive in its investment in the space and pursue partnerships to extend research in drug discovery, delivery mechanisms and clinical research innovation.

To incentivise this, we must ensure that innovation is genuinely groundbreaking. There is a need to raise the bar at the end-point of clinical research to ensure that the best treatments are prioritised and that superiority over current treatments is demonstrated. In the value-based pricing system, this will be crucial in providing returns on investment.

It is time for all of us to come together to find a solution that works. Given the global market value of $40 billion, there is an opportunity waiting to be realised and the pharmaceutical industry must step forward, seize it and change the course of global health.

Alan Westwood is Managing Director of Matoke ® Pharma. Go to www.matokeholdings.com/pharma M AG A ZI N E | A P R I L 2019 | 21

Above& Rich Quelch asks whether the new Falsified Medicines Directive goes far enough across the supply chain.

A

s one of the largest health threats to populations around the world, falsified medicine has become a central focus of governments, agencies and pharmaceutical companies over recent years.

Now considered to be the world’s largest fraud market, thought to be worth over $200 billion per year according to PwC research, efforts have been ramped up to make the production and circulation of fake medicine more difficult.

A major step forward was taken recently when the EU’s Falsified Medicines Directive (FMD) came into full force on 9 February.

All new prescription medicine in Europe must now bear two new safety features: an anti-tampering device (ATD) and a unique identifier (UI) in the form of a 2D barcode.

However, does the FMD go far enough in combatting counterfeiting, falsification and tampering across the pharma supply chain?

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THE ‘FAKE’ PHENOMENON

SHORT-TERM CHALLENGES

While many people may be concerned with fake news, the majority of people are unaware of the growing danger posed to them by fake medicine in hospitals, chemists and ‘e-pharmacies’.

Falsified medicines do not pass through any of the normal checks for quality, safety or efficacy, meaning patients who take them are likely to be taking medicines which fail to treat or prevent illness. It could also cause them serious harm and even death depending on the medicine’s ingredients.

This rising trend also serves to widen existing health inequalities between leading and developing countries.

According to WHO: ‘It’s estimated one in 10 medical products currently circulating in low- and middle-income countries are either substandard or falsified’. In addition, it serves to undermine global efforts to combat antimicrobial resistance if patients aren’t taking high-quality antibiotics.

In countries across Europe, the threat level remains low through legitimate channels, but it certainly can’t be ignored.

The FMD legislation is an important piece of armoury for the European supply chain to protect patients now and in the future.

The pharmaceutical industry, by its very nature, has a highly-complicated supply chain management network and as such, the FMD has tried (with due credit) to simplify and rebalance the burden of responsibility for tracking pharmaceutical products and identifying fakes before they reach the end user.

However, the adjustment period won’t be straight-forward as previously disparate national bodies from member states learn to work with each other.

Short-term, there will be products already in the supply chain which don’t include the now mandatory features. In fact, according to the British Medical Association, only 15% of existing products are estimated to be compliant at this point in time.

In many markets, including the Nordics, Germany and Portugal where item number systems were already used extensively before the FMD, usage of legacy product codes will need to be phased out. Adding further complication, Greece and Italy will be outside the European Medicines Verification System until 2025.

It may also take time for the dust to settle and to understand how the FMD will work in action. While the rules on serialisation are clear, legislation provides much less

F E AT U R E

WORDS BY Rich Quelch

detail on tamper-evidence devices, other than to make their addition mandatory, which leaves things open to interpretation by member states.

While the EU has set in motion a tide of changes to reduce the threat of falsified medicines, it’s only been able to go as far as it can, politically. A global supply chain demands a global system but the FMD can only cover firms manufacturing and distributing drugs within the EU zone.

Switzerland is the world’s second largest exporter of medication ($41.3 billion in 2017), the US is the 5th ($21.1 billion) and India 10th ($11.9 billion) and each has its own national strategies in place which legally do not have to align with the EU’s Directive.

The rise of internet pharmacies also makes it difficult to protect FMD standards; the EU has mandated all authorised e-pharmacies display a common logo, but the responsibility ultimately lies with the consumer to recognise this and make a judgement call before purchasing.

Finally, there’s Brexit and the shadow of doubt cast over the FMD and the UK’s future relationship. It’s unclear what this might look like but the signals so far from the UK pharmaceutical industry and NHS leaders has been one of positivity, classing the new safety system as the ‘world’s best’.

Along with pressure from bodies such as the British Medical Association on the Government to fund the equipment required to facilitate the FMD, it’s likely the UK will see similar product regulation in some capacity, whether through the FMD or not.

If anything, leaving the EU could mean the UK Government places even greater responsibility on the pharmaceutical industry to protect patients from falsified medicine and become a world-leader in tamper-proof design.

GOING ABOVE AND BEYOND

The comprehensive nature of end-to-end drug traceability in a market which is increasingly global means FMD compliance shouldn’t be the final step.

There’s a real opportunity for manufacturers, working in collaboration with packaging companies, to create the next generation of tamper-proof technology and become pioneers in digital packaging.

Perennial encryption technology is a largely untapped innovation, preventing duplication and replication of 2D and 3D unique identifiers. By issuing a single-use URL, perennial encryption technology renders any cloning attempt useless. Only the secure cloud host knows the sequence of coding and any attempt to re-use the previous URL is detected by the cloud host

and an invalid message is issued warning the product has been copied. The same process can be used to identify tamper evidence too.

Intelligent tracking systems, built into medicine packaging, are also a developing science which will prove valuable in the fight against falsified and counterfeit medicine. As a live programme, the location of a product at any given time can be seen remotely in real-time together with its endto-end journey, revealing any unauthorised routes or interventions.

Not only can technology aid the pharmaceutical industry in removing falsified products from its supply chain, the data insights gained can be used to increase efficiencies. Despite companies innovating in the field of science to discover, develop and market medicines more efficiently, many companies have failed to upgrade their supply chains.

With biologic and personalised medicine already re-shaping the industry, there needs to be a two-way street where information is being used to inform the downstream flow of products. Data holds the key to creating efficient, safe and demand-driven supply chains which benefit manufacturers, health systems and above all else, patients.

Rich Quelch is Global Head of Marketing at Origin. Go to www.originltd.com M AG A ZI N E | A P R I L 2019 | 2 3

ABPI Unravelling the

PMCPA administration of the ABPI Code

I

t has long been communicated to the UK pharmaceutical industry that the Prescription Medicines Code of Practice Authority (PMCPA) welcomes all input and feedback on the ABPI Code of Practice. But what does this actually mean, what does the PMCPA do with such feedback, and what motivates feedback or prevents it from being given?

As experts on the ABPI Code, our client base allows us to have a comprehensive view in relation to its administration and, in particular, the frustrations felt by pharmaceutical companies. We consider it highly constructive and a positive step to be able to provide healthy challenges of PMCPA decisions and/or seek clarification on their rulings.

We’ve documented frustrations and suggested solutions to help the wider industry improve its understanding of the way that the ABPI Code is administered.

WHAT IS THE PMCPA?

“The Prescription Medicines Code of Practice Authority was established by The Association of the British Pharmaceutical Industry to operate the ABPI Code of Practice for the Pharmaceutical Industry, independently of the ABPI.” In other words, the ABPI owns the Code and since 1993, the PMCPA has administered it.

According to the PMCPA website, it: • Operates the complaints procedure • Provides advice and guidance on the Code • Provides training on the Code • Arranges conciliation between pharmaceutical companies when requested to do so • Scrutinises samples of advertising and meetings to check their compliance with the Code.

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

The role of the PMCPA appears to have expanded over the years to managing Compliance Network Meetings as well as any updates to the Code. Unsurprisingly, decreased resources at the PMCPA and increases in other work have meant frustrations have been expressed about PMCPA operations and processes around the handling of complaints.

Some of this feedback has been provided to the PMCPA, but some individuals and companies choose not to disclose this directly but rather express it to us.

CONTENT OF THE CODE

The public consultation on suggested proposals to amend the Code is a critical step in ensuring everyone (inside and outside the industry) has a chance to have a say on the content of the Code.

However, this process has, in the past, been owned and managed by the PMCPA with varying degrees of oversight from the Appeal Board and the ABPI Board.

Although bodies such as the ABPI Code Working Group (made up of industry representatives that work with the Code) met throughout 2018 to consider ways to streamline and simplify the Code, it is unclear how their outputs were further considered and the criteria that were met for some of their comments to make it through to public consultation.

The ABPI has an opportunity to re-establish its ownership of the Code moving forward, by managing the public consultation in a transparent and consultative manner.

The public consultation on the 2020 ABPI Code and PMCPA Constitution is expected to open at the end of this summer.

COMPLIANCE NETWORK MEETINGS

Since 2012, the PMCPA has hosted quarterly meetings at their offices with compliance managers. These PMCPA Compliance Network Meetings were intended to be a forum whereby company attendees could discuss topics of interest, share experiences and best practice with one another, as well as allow discussions with the PMCPA, so that their case rulings could be better understood and therefore adhered to.

Given the PMCPA only administer the Code and that the ABPI’s own expert networks are already established under their ownership, it is unsurprising that the ABPI has decided that it will, in future, run these meetings – the PMCPA will continue to participate and share its thoughts on recent cases and developments.

The first ABPI Compliance Network meeting took place at the ABPI’s offices on 15 March 2019.

PMCPA PROCESSES

There has been concern for some time about the time taken for the PMCPA to notify a company of its ruling, and the lack of transparency overall in the complaints process. In addition, frustrations have been expressed about complex and lengthy case reports and the ability for an average reader to understand fully the key learning points in order to remain Code-compliant.

With this in mind, a standard operating procedure (SOP) for complaints was developed to provide standardisation, transparency and oversight. Many companies asked in 2018 for this SOP to be incorporated into the PMCPA Constitution.

Whilst the ABPI acknowledged the pressures on the PMCPA and suggested the SOP is considered for implementation, this isn’t likely to occur until 2020.

Through clear timelines, case ruling forms and tabulated summaries of case rulings, this SOP will bring the industry much-needed clarity, as well as help the PMCPA to manage complaints more quickly and effectively, producing rulings that are easier to understand.

It is clear that appropriate feedback mechanisms must exist to allow the PMCPA to fully understand these frustrations.

Although this article describes four ways in which compliance with the Code may be improved, it is valuable for all involved, if feedback is constructive, action is taken, and improvements are carefully measured.

Dr Rina Newton is Managing Director of CompliMed. Go to info@complimed.co.uk

ABPI

The public consultation on suggested proposals to amend the Code is a critical step in ensuring everyone has a chance to have a say on the content of the Code

WORDS BY Dr Rina Newton

INDUSTRY COMMENTS ON PMCPA OPERATIONS The summary below is reflective of some of the comments that we receive on a regular basis about the administration of the ABPI Code.

THERE IS A LACK OF:

THERE ARE CONCERNS ABOUT:

• Clarity within the ABPI Code, PMCPA case rulings and PMCPA guidance on specific activities and materials • Transparency on proposals to amend the ABPI Code and the source of these • Input from ‘average’ readers of the Code into the development of PMCPA guidance • Quick response to questions posed to the PMCPA • Transparency around how PMCPA mistakes are corrected and prevented • Standards to ensure transparent and consistent complaint management.

• Lengthy delays on receiving PMCPA rulings, responses, guidance etc • Challenging rulings or seeking clarification on PMCPA decisions • Procedural unfairness • Inconsistency in case rulings • PMCPA workload • Perceived increase in mistakes, for example wrong Clauses alleged • PMCPA tweets that appear to reprimand companies (without Appeal Board requesting a public reprimand) • PMCPA knowledge of digital technology.

M AG A ZI N E | A P R I L 2019 | 2 5

Liz Cross, advanced nurse practitioner and non-medical prescriber, is taking huge steps in reducing the unnecessary prescribing of antibiotics to address antimicrobial resistance (AMR).

INTERVIEW BY Emma Morriss

hat is your background? I’m a shop floor nurse who is passionate about trying to improve primary care. I’m an advanced nurse practitioner and non-medical prescriber working in a large GP practice in Watford, Hertfordshire. My clinics are varied; divided between chronic disease management, minor illness and anything else you would see your GP nurse for.

Tell me about the AMR pilot, how did it come about? This project was really born of frustration; essentially, I was looking for a more efficient way of running my minor illness clinics. During my busy peak winter months, about half the patients presenting to my clinics will have a cough or respiratory infection and up to 50% of these patients would be seen more than once for the same infection.

Imagine, Mrs A comes into clinic with her chesty cough with fevers and green

phlegm she has had for over a week, you give her a course of antibiotics and tell her if she is no better in a week come back.

Guess what? She comes back! If I had correctly identified that her cough was caused by a virus which may last for two to three weeks, but will get better with time and rest, perhaps she wouldn’t need that second appointment.

I wanted to know why we can’t get the diagnosis right at the first presentation, reducing the need for the patient to come back. I noticed that we have two main problems. Firstly, out in general practice, without easy access to diagnostics or imaging, it’s difficult to determine who will benefit from a course of antibiotics and who would get better by themselves.

Secondly, if the patient is worried and believes they need antibiotics, it’s really hard to convince them otherwise in a 10-minute appointment.

C-reactive protein (CRP) is a biomarker produced by the liver in response to inflammation. When used alongside standard history-taking and examination, it can help the clinician decide if a course of antibiotics would be appropriate for a chest infection. Normally, this test is done in a lab, but now we can analyse a finger prick blood sample and get the results back in less than four minutes.

Breaking the cycle WHY ANTIBIOTICS AREN'T ALWAYS THE ANSWER 2 6 | P H A R M A FI EL D.CO.U K

COFFEE BREAK

antibiotic prescription at initial presentation by around 62% and follow-up consultation by around 32%. Compared to the group using standard care, the testing group saw a reduction in presentation due to side effects of antibiotics, reduced visits to out-of-hours and A&E and reduced requests for chest x-rays. Annual cost projections based on this suggest that the mean cost of associated healthcare events per patient is lower for practices where CRP testing is available, even after overhead costs have been taken into account.

I wanted to know why we can’t get the diagnosis right at the first presentation, reducing the need for the patient to come back

Will there be a national roll out? I’m everhopeful there will be a national roll out. Some practices have made great progress and really reduced antibiotic prescribing, and thanks to national awareness campaigns, patients are certainly more aware of the dangers of taking too many antibiotics. However, for those practices that are struggling to make changes, I think CRP is a practical option.

How did you get involved in it? The project started off small and has grown. I called up a couple of diagnostic companies and asked them to demonstrate their kit. One company offered me the loan of a machine for three months and 100 tests.

Using the National Institute for Health and Care Excellence guidelines, I started using the tests in my clinics then reviewed the patients’ notes after a month to see what happened to them. I compared these against patients presenting to my clinics in the corresponding months of the previous year. In doing so, I was encouraged that my prescribing rates had fallen dramatically, but I was astonished that my unscheduled re-attendances had halved.

This really piqued my interest. I’d reduced my antibiotic prescriptions and saved appointments in our busiest winter period.

A double win! So I applied for an NHS Innovation Award and won a £10,000 seed fund to roll it out to five practices in Herts

Valley Clinical Commissioning Group (CCG). Supported by a National Institute for Health Research (NIHR) fellowship, I was able to dedicate more time to the project.

At Herts Valleys CCG, we trialled CRP testing over a three-month winter period in five high to medium antibiotic prescribing GP practices. We then compared the prescribing rates against three similar local practices using standard care.

We evaluated how often patients were prescribed antibiotics. We also reviewed patients’ notes after 28 days to see if they came back for another appointment, presented to A&E, called out of hours, required a chest x-ray or were prescribed more antibiotics.

We found that patients in the testing group were prescribed antibiotics less frequently and were also less likely to come back for unplanned follow up appointments.

What have been the results? The availability of CRP testing equipment has reduced

What else are you doing around antimicrobial resistance? I do quite a bit of public speaking now. I was invited to present the work in Mumbai, India as part of the Longitude Prize, and I’ll be heading to Los Angeles and Boston to do the same.

Uptake across the five practices was variable. One of the barriers was the increased workload of doing a test within a busy clinic. To address this problem, I have another project where we have based the CRP test within a community pharmacy. By changing the patient flow, we hope that more GPs will offer the tests and the community pharmacist will get more footfall.

How have patients benefitted from CRP? CRP is a practical solution to a real problem.

Patients love it. They are reassured that they have had a thorough examination by their local GP or nurse. Near-patient diagnostics takes the consultation from appearing rather subjective to giving them something objective, helping them to understand why antibiotics were or weren’t prescribed for their cough. They are reassured that they are getting a thorough examination at their local GP surgery without having to travel to hospital for x-rays or tests. Liz featured in the Pf Power List published in the October issue of Pf Magazine. www.pharmafield.co.uk/in_depth/pfpower-list-shaping-pharma-healthcare-sector M AG A ZI N E | A P R I L 2019 | 27

WORDS BY Emma Morriss

MS KEY FACTS

Multiple Sclerosis IS A DISEASE AFFECTING THE CENTRAL NERVOUS SYSTEM (THE BRAIN AND SPINAL CORD)

AROUND

110,000

PEOPLE IN THE UK HAVE MS APPROXIMATELY

100 PEOPLE ARE DIAGNOSED WITH MS EACH WEEK.

MS IS THE MOST COMMON CONDITION OF THE CENTRAL NERVOUS SYSTEM AFFECTING YOUNG ADULTS

MS is a lifelong condition, but it is not a terminal illness

Understanding Multiple Sclerosis Multiple sclerosis (MS) is a neurological condition affecting the central nervous system. ‘Sclerosis’ means the scarring or hardening of tiny patches of tissue; it is called multiple sclerosis because it happens in more than one place in the brain and/or spinal cord.

TYPES OF MS THERE ARE THREE TYPES OF MS

Relapsing remitting MS Secondary progressive MS Primary progressive MS

R

elapsing remitting MS is the most common form of the condition, with around 85% of people receiving this diagnosis. It means that symptoms can fluctuate from aggressive flare-ups to mild relapses, to periods of good health or complete recovery.

Relapses can vary in frequency, severity and time between attacks, making it difficult to predict. It is quite common for people to have one or two attacks a year and the level of recovery may not be the same with each attack. Disease modifying drugs (DMDs) may decrease the number and impact of relapses (see opposite).

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

MS IS NOT INFECTIOUS OR CONTAGIOUS SO IT CAN’T BE PASSED ON THROUGH CONTACT WITH SOMEONE WITH MS

EVERYONE’S MS IS DIFFERENT so no two people will have the same range and severity of symptoms, even if they are closely related.

Source: MS Trust

Secondary progressive MS can follow relapsing remitting MS. Commonly, a person’s disability increases but they have fewer or no relapses. As with all other types of MS, the way people experience secondary progressive MS can vary considerably.

Finally, there is primary progressive MS, which is less commonly called chronic progressive MS. Progressive means that disability increases from the beginning and it can be rare to have any relapses. However, some people may have times of improvement or times when symptoms remain steady.

THERAPY AREA

SYMPTOMS

In the last fifteen years, the drug options for treating relapsing remitting MS have gone from almost nothing to an array of choice

There are many possible symptoms of MS. The most common symptoms include:

Fatigue

Issues with eyesight

Poor sleep

DRUGS IN DEVELOPMENT

Although there are many potential MS drugs in early stages of development, according to the MS Trust these are of most interest to people living with MS today: RELAPSING REMITTING MS

Problems with balance or coordination

Difficulties regulating the bladder or bowel

Brain fog, including poor concentration or forgetting things

ATX-MS-1467 Evobrutinib Ofatumumab Ozanimod Ponesimod Ublituximab

Phase II Phase II Phase III Phase III Phase III Phase III

SECONDARY PROGRESSIVE MS

Temperature sensitivity

Pain, numbness or tingling of the skin

MS TREATMENTS

In the last fifteen years, the drug options for treating relapsing remitting MS have gone from almost nothing to an array of choice.

The first available medications, injectable interferons, have now been joined by pills and infusions, with generics now also entering the market. There are currently 14 different DMDs for relapsing remitting multiple sclerosis.

However, the UK has one of the lowest uptakes of DMDs in Europe, and there is considerable variation in prescribing practice across the UK. To address this, the MS Trust has developed a tool to make it easier for people with relapsing remitting MS to explore their options and be better informed about treatments. The tool has several key features: • Regularly updated to reflect new guidelines from National Institute for Health and Care Excellence, the Association of British Neurologists and research findings • New drugs added as they become available • Users can select up to three drugs at a time and compare efficacy, mode of action, side effects and monitoring requirements.

Amiloride Fluoxetine Ibudilast Masitinib MD1003 (Biotin) Opicinumab (Anti-LINGO-1, BIIB033) Riluzole Simvastatin Siponimod

Phase II Phase II Phase II Phase III Phase III Phase II Phase II Phase III Licensing

PRIMARY PROGRESSIVE MS

Ibudilast Phase II Idebenone Phase II Laquinimod Phase II Masitinib Phase III MD1003 (Biotin) Phase III Ocrelizumab NHS appraisal Opicinumab Phase II (Anti-LINGO-1, BIIB033) MYELIN REPAIR OR NEUROPROTECTION

Bexarotene

Phase II

M AG A ZI N E | A P R I L 2019 | 2 9

THERAPY AREA

My advice to anyone wanting to switch his or her DMD is, only try and fix a cog if it is broken!

M

PERSONAL STORY

CHOOSING THE BEST TREATMENT FOR YOU Jane shares her experience of making a decision about treatment.

3 0 | P H A R M A FI EL D.CO.U K

y name is Jane, I’m 25 years old and I live in Scotland.

I work as a nurse within the community. One of my passions from a young age has been sport, in particular netball, which I love to play.

Only six weeks after handing in my nursing dissertation I was diagnosed with MS. This was following a period of double vision that occurred very suddenly, and an MRI. I was subsequently transferred over to the care of a neurologist specialising in MS. Around this time, I was also introduced to the most excellent MS specialist nurse, Mhairi.

Around six months post-diagnosis I started on my first DMD. In discussion with my nurse Mhairi and using the MS Trust’s MS Decisions resource, I was able to make the most informed decision regarding treatment choice. Initially I commenced on Tecfidera, due to its efficacy rate, balanced with non-invasive delivery and because it was in simple daily tablet form.

This worked well to begin with, but I then began to lose weight quickly without trying so I was advised to stop.

I then chose to start on Avonex. Despite the lower efficacy than Tecfidera and being in injection form, I decided this would be best for me. I felt comfortable learning how to inject myself just once per week and Avonex had also been about for some time, so lots of research had been conducted; I felt it was reliable. I remained on Avonex for just over a year, keeping very good health, working four days a week and playing netball weekly.

Unfortunately, in May 2017 I had quite a major relapse, which was triggered by a severe migraine. On having a further MRI, it was confirmed my MS had significantly progressed. At this point my neurologist advised me that I should begin a second line MS DMD treatment. He advised me to look at three drugs, but one was automatically disregarded due to a preexisting health condition I have. My choices

were alemtuzumab (Lemtrata), which is administered as an in-patient in hospital via an intravenous infusion in two treatment courses, 12 months apart, and natalizumab (Tysabri) an intravenous infusion administered once every four weeks.

Ihad many factors to weigh up including possible side effects from both treatments.

I opted to have alemtuzumab. As I write this, I am two weeks post second round of alemtuzumab. This has not been an easy journey and it took me many months until I regained any sort of normal life after my first infusion, which I failed to prepare for mentally. I did eventually recover and was able to return to work. Now I have had my second infusion I am focusing on recuperation and I cannot wait to get back on the netball court.

My advice to anyone wanting to switch his or her DMD is, only try and fix a cog if it is broken! If your DMD is working for you, don’t switch, but if you relapse or side effects become problematic, consult your MS nurse and access the MS Decisions resource from the MS Trust. You can then weigh up your options and decide what is personally best for you. With thanks to the MS Trust.

Go to www.mstrust.org.uk

For MS information you know you can trust www.mstrust.org.uk

The MS Trust website is the go-to place for trusted information about MS. We cover a range of topics from MS symptoms and treatments to ways to live with MS day to day.

Over 50,000 people visit the site each week to access reliable and free MS information.

www.mstrust.org.uk Find us on

 Alistair Donnachie of

Double winner

Mylan, sponsors of the Experienced Account Manager Pf Award, Claire Smith and host of the Pf Awards 2018 Dinner, Hal Cruttenden

Claire Smith won two Pf Awards in 2018 and she hasn’t stopped winning since.

INTERVIEW BY Emma Morriss

T E L L M E A B OU T YOU R B AC KG ROU N D I started in the industry in 2001, fresh from university. I had studied Business and Marketing Management, and at the time it was unusual for pharmaceutical companies to take on candidates without a science background. Nonetheless, I was taken on by Servier because I had a first class honours degree – the hard work did pay off!

I started out as a medical information executive and I had initially planned to go into marketing after a short stint in this sales role. But once I was out in the field, I loved it and couldn’t imagine working in an office; every day was different, and I was meeting new people and learning about the amazing differences we can make to patients’ lives.

I’m married with two children and we live in the Herefordshire countryside. I’m into fitness – I love running, netball and skiing (although I’m not as good as my children now!) and we travel as much as we can. I’m also an ambassador for the NHS Blood Donation service and speak at donor awards ceremonies, having needed lifesaving blood a few years ago.

W H AT H A S BE E N YOU R C A R E E R PAT H T O YOU R C U R R E N T ROL E? I have always been in a field-based role, mostly in cardiology, and held many different roles including hospital specialist and regional business manager, and in project management too. Having worked

32 | P H A R M A FI EL D.CO.U K

On the night of the Pf Awards, I was delighted to hear I’d made the final six, but winning was a total shock

for Servier for 15 years, I wanted to focus on making a difference to patients with heart failure and transitioned to Novartis. One thing has remained the same since the start of my career – I have always put patients at the heart of what I do each and every day.

W H AT D O YOU E NJOY T H E MO ST A B OU T YOU R JOB? As an Account Manager no day is the same, and I’m often in different parts of the Midlands every day. Working with heart failure specialists is amazing when I hear how someone’s life has changed dramatically because they have had access to our medicines. These stories motivate me to ensure our medicines reach the people who need them, no matter where they live.

I’m passionate about ensuring patients don’t have to wait for medicines. My daughter was

admitted to hospital with asthma several times before getting the right treatment, and because of this I understand how not only the patient, but also those around them, are affected when someone falls ill.

At Novartis, we have a culture of working cross-functionally. I am currently actively working with the brand team and providing field force insights to shape the brand strategy. We’re unique at Novartis in that we work as one team with one purpose, to work faster for patients. Since our new Chief Executive has taken over, Vas Narasimhan, we are working in a culture that is inspired, curious and ‘unbossed’ – it’s so exciting and different to how we’ve worked in the past. Consequently, it comes as no surprise to me that Novartis has been certified as a Top Employer for the sixth year in a row.

The motto here is ‘I came for the job, I stay for

P F TA L E N T

the culture’, and I do believe this is correct – I work with some of my best friends.

YOU WON T H E E X PE R I E NC E D AC C OU N T M A NAG E R A N D C OM M E RC I A L I N NOVAT ION AWA R D S AT PF AWA R D S 2 018 , T E L L M E A B OU T YOU R W I NS .

In 2018, the competition was the biggest it has ever been. The application process and Assessment Day were challenging, but actually really enjoyable. During the assessment, it was great to be surrounded by my peers – everyone was so supportive, and this really helped me forget the nerves and share my passion for the role.

On the night of the Pf Awards, I was delighted to hear I’d made the final six, but winning was a total shock! It was a lovely surprise, and one I will always remember as a highlight in my career. It was great to be recognised after many years in the industry doing my best to bring medicines to the patients who need them.

It was also wonderful to be able to celebrate my Commercial Innovation Award with my team members – I had worked really hard with the brand team on improving digital communications with our customers, and successfully scaled up digital as the primary format for our meetings.

DI D I T H AV E A N I M PAC T ON YOU R C A R E E R? Last July, I was delighted to be promoted to a Principal Key Account Manager (KAM) at Novartis, in recognition of my success at the Pf Awards 2018 as well as my performance as Senior KAM. I was also recognised by my peers, winning the Players’ Player award in our franchise last year.

The global Novartis team were also keen for me to share insights into my award success with the global field force, which enables meto act as a role model to others.

YOU R E C E N T LY WON T H E NOVA RT IS C OU N T RY PR E SI DE N T ’ S AC T I VAT E AWA R D, W H AT IS T H IS , W H AT DI D YOU W I N I T FOR , A N D W I L L I T H AV E A N I M PAC T ON YOU R C A R E E R? At Novartis, we recognise associates who have collaborated not only with their team and franchise, but right across the company. This year, I was awarded the Activate Award by our Country President, Haseeb Ahmad, whom I have worked with throughout the year. I’ve had the fantastic opportunity to consult with him, to give him an insight into working in the field. This has helped reshape our

culture to allow us all to work freely with one another to get the job done in the right way – by putting the emphasis on patients rather than sales. To demonstrate this new one-team approach at our company conference, we even made a ‘carpool karaoke’ video together!

I don’t know of any other pharmaceutical companies working in this way, without a hierarchy. This year is the Year of the Field at Novartis, so it’s a pivotal time for recognising the people who are the face of the company – I’m really excited about what this year will bring.

IS T H E R E A N Y T H I NG E L SE YOU ’ D L I K E T O A DD? As I’m a working mum, I was particularly proud to win the award on International Women’s Day! I’d recommend anyone to go to the Pf Awards, challenge yourself, meet your peers, have fun, share your passion for the job you do, and who knows what might happen!

Claire’s winner’s interviews at Pf Awards 2018 are available online. Go to www.pfawards.co.uk/winners-interviews-2018/

M AG A ZI N E | A P R I L 2019 | 3 3

P F TA L E N T

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

Hannah Alderton

PHARMA

Ameet Nathwani Sanofi has appointed Ameet Nathwani MD as Chief Digital Officer in addition to his current role of Executive Vice President, Chief Medical Officer. Dr Nathwani has more than 20 years’ experience in the industry.

AGENCY

Katie Bright

PHARMA

HEALTHCARE

Dr Hilary Jones

Sally Warren

Dr Hilary Jones has been appointed

by London-based nutraceutical company MedTate as a NonExecutive Director. Chief Executive and founder, Pete Tate, said: “Dr Jones is an excellent and extremely valuable addition to our board.

He will be key in developing our educational resources for both consumers and pharmacists.”

Sally Warren has been named the Director of Policy at The King’s Fund.

Sally held positions at the Department of Health and Social Care, Public Health England and the Cabinet Office.

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

Makara Health has promoted Katie Bright to Director.

Katie has 16 years’ experience in healthcare and will focus on engagement programmes spanning training, medical education and patient engagement.

PHARMA

Rajesh Chopra Artios, a DNA Damage Response company, has appointed Professor Rajesh Chopra as Non-Executive Director.

Professor Chopra was Corporate Vice President of Translational Research at Celgene and was on the Oncology leadership team at AstraZeneca. He is currently the Director of the Cancer Research UK Cancer Therapeutics Unit.

PHARMA

HEALTHCARE

Dr Allan Jordan & Ms Louisa Jordison

Prerana Issar

Sygnature Discovery has made two appointments, Dr Allan Jordan and Ms Louisa Jordison. Allan joins as Director of Oncology Drug Discovery from Cancer Research UK. Louisa will be the new Director of Strategic Planning involved in ambitious planning, growth and capital projects activities.

NHS Improvement and NHS England have appointed Prerana Issar to the role of Chief People Officer. The new position is part of the NHS Executive Group and will play a leading role in ensuring that the NHS in England has enough people, with the right skills and experience to deliver the improvements for patients set out in the NHS Long Term Plan.

AGENCY

Emma Banks

PHARMA

Patrice Grand Patrice Grand has been appointed as Mundipharma’s European Director of Corporate Communications.

He has over 30 years’ experience in the industry.

Emma Banks has been named Managing Director of ramarketing as its founder, Raman Sehgal launches the first office in America.

Raman said: “Emma is a well-known industry figure with a wealth of senior level experience. Her experience of growing a technology company into a highly successful international operation makes her an ideal candidate for the role.”

PHARMA

Kieran Chouhan Recipharm, a contract development and manufacturing organisation (CDMO), has appointed Kieran Chouhan as the new Director of Business Management for the USA and Canada. Kieran will be responsible for sales and business development for the CDMO’s commercial manufacturing services.

M AG A ZI N E | A P R I L 2019 | 35

CAREERS

CAREER GUIDE

SOCIAL MEDIA DOS AND DON’TS Your social media presence could be the clincher or your collapse when it comes to looking for a job. Here’s how to present your online self in its best light. WORDS BY Amy Schofield

O

ur social media profiles are the virtual face that we present to the world.

Some people carefully curate that online image, while others splurge the good, the bad and the ugly of their lives onto the screen. While your friends might love that photo of you with a traffic cone on your head from a wild night out, potential employers might not.

If you’re looking for a job and you think that recruiters aren’t looking for how you present yourself online, you’re could be in for a shock.

Graham Hawthorn, Managing Director, CHASE, said: “If you are job hunting you are going to be doing research on the job and company you are applying for. However, remember that the people on the other side are also doing that, but to research you!”

Hannah Light, Digital Marketing Manager at Star, explained that a very high proportion of recruiters look at the social media profiles of their prospective employees as a matter of course: “These days people are more likely to connect with people over social media than any other form of communication, at least initially,” she said. “This also extends to employers. 70% of companies use platforms like LinkedIn and Facebook to get an idea of what a candidate is like, and if they’d be a good company fit. Or not!”

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

CAREFUL POSTING

Graham says that candidates need to be vigilant about what they post: “Utilising social media channels is now an established part of the job search process. But there is another side to this; people not thinking about what they have said online and it coming back to haunt them,” he cautioned. “Today there is one golden rule about publishing online; always assume your current or future employer is reading what you write or post.”

Hannah advised taking a second to think about what’s on your various social profiles, and whether you should be worried: “Look yourself up online; what do you find? Think about your digital footprint. Are there any photos you probably shouldn’t be tagged in? Could your profiles do without those two or three 1am statuses?” she said. “Recruiters want to know that you are someone they would be happy to put forward to their client for interview or an assessment centre. Do your results suggest that?”

Make sure you use social media as a force for good. “When it comes to looking for a new role, social media can absolutely be your friend, and LinkedIn is the place to be. Use it to show off!” Hannah added. “Share articles that you find interesting, comment on things that you have an opinion on, build up your profile with useful contacts and join groups that focus on your dream job sectors. Use social media to demonstrate to potential employers that you are someone worth investing in!”

Go to www.chasepeople.com & www.starmedical.co.uk

70%

of companies use platforms like LinkedIn and Facebook to get an idea of what a candidate is like

GRAHAM’S SOCIAL MEDIA TIPS:

Check your security settings Who can see what you post?

Photos What are the photos like?

Do you need to untag/delete some?

Text updates Is there anything too controversial that might be deemed ‘inappropriate’?

Tag settings Can you approve photos/posts you are tagged in before they appear?

CHECK OUT OUR

NEW WEBSITE

Find your perfect job with Pharmajobs.

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Discuss your online recruitment strategy today 01462 476119 or hello@pharmafield.co.uk

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W H E R E TA L E N T G R O W S

NURTURING 'CHASERS' SINCE 1998.

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