January 2018 PHARMAFI E LD.CO.U K
WELCOME
EDITOR
John Pinching john@pharmafield.co.uk A S S I S TA N T E D I T O R
Amy Schofield amy@pharmafield.co.uk C R E AT I V E D I R E C T O R
Emma Warfield emma@pharmafield.co.uk COMMERCIAL DIRECTOR
Hazel Lodge hazel@pharmafield.co.uk SALES & MARKETING MANAGER
Rachel Cresswell rachel@pharmafield.co.uk FINANCIAL CONTROLLER
Fiona Beard finance@e4h.co.uk P f AWA R D S
Melanie Hamer melanie@e4h.co.uk PUBLISHER
Karl Hamer karl@e4h.co.uk pharmafield.co.uk e4h.co.uk @pharmafield @pharmajobsuk HEAD OFFICE
Spirella Building Bridge Road Letchworth Garden City Hertfordshire SG6 4ET United Kingdom Cover illustration by Alex Buccheri alexbuccheri.com The content of and information contained in this magazine are the opinions of the contributors and/or the authors of such content and/or information. Events4Healthcare accepts no responsibility or liability for any loss, cost, claim or expense arising from any reliance on such content or information. Users should independently verify such content or information before relying on it. The Publisher (Events4Healthcare) and its Directors shall not be responsible for any errors, omissions or inaccuracies within the publication, or within other sources that are referred to within the magazine. The Publisher provides the features and advertisements on an ‘as is’ basis, without warranties of any kind, either express or implied, including but not limited to implied warranties of merchantability or fi tness for a particular purpose, other than those warranties that are implied by and capable of exclusion, restriction, or modification under the laws applicable to this agreement. No copying, distribution, adaptation, extraction, reutilisation or other exploitation (whether in electronic or other format and whether for commercial or non-commercial purposes) may take place except with the express permission of the Publisher and the copyright owner (if other than the Publisher).
H
Letter from the Editor
ello and, above all, welcome to 2018; a uniquely-titled year and so full of promise. Where will it take us and what will it yield? No one quite knows, but at this moment, we hold its mystery to our hearts and cherish its potential – for the time being at least. With that in mind, our cover story looks proudly forward, without so much as a glance in the rear-view mirror, as our panel of experts stare into the snow globe and, through the blizzard, make their NHS, pharma, political and wider healthcare predictions for the next 12 months. As we herald the New Year, Pf Magazine also invites several new features. ‘High Fives’ selects a single subject and brings together the miscellany surrounding it; comments, debate, trivia and breakthroughs. On this occasion, the focus is on operating theatres. ‘NHS Prescribed’ takes an expansive look at the main talking points in public health, while ‘Two Takes’, our new opinion battle, highlights a subject, such as NHS privatisation, and hands the stage over to two experts with diametrically opposing views. Meanwhile, ‘Pf Awards: This is Your Life’, as the title suggests, looks at how winning an award can change your life forever. It should be fun! Our usual column musketeers have, yet again, proved the pen mightier than the sword with some timely observations from the arenas of pharma, politics and pharmacy. We also invite a new digital columnist in the form of NHS Digital’s Martin Moth. Needless to say, he isn’t afraid to fly close to the fire. Following the most indulgent period of the year, our featured therapy area looks at the obesity conundrum, how it reflects on society and the impending crisis for the NHS. Also, look out for part one of our series of special PharmaTalent interviews underlining the incredible contribution of women to our industry. Our bevvy of regulars and much more besides means that 2018 has started with a flourish. Happy New Year, folks,
The information contained in this magazine and/or any accompanying brochure is intended for sales and marketing professionals within the healthcare industry, and not the medical profession or the general public.
Pf Magazine is published monthly. For a free U.K. subscription visit pharmafield.co.uk/subscribe.
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M AG A ZI N E | JA N UA RY 2018 | 1
CONTENTS Bringing you this month’s essential headlines HIGH FIVES
Five fascinating things about… operating theatres F E AT U R E
What does the year 2018 have in store?
January MAGA ZINE
OPINION
David Thorne on the commissioning maze COFFEE BREAK
Will pharmacies transform general practice?
HAVE YOUR SAY: Does your company take on orphan or rare diseases? Should people’s lifestyle choices determine whether they receive free healthcare? Does mindfulness have a role in treating patients? We’ll be covering these issues in the next Pf Magazine – want to contribute? GET IN TOUCH: hello@pharmafield.co.uk
OPINION
Claudia Rubin on the life sciences deal enigma
@pharmafield
@pharmajobsuk
Pf Magazine
MARKETING
The key to maximising sales is embracing change OPINION
Deborah Evans attends a mental health course
BE IN THE KNOW. the R I S E of R DOCTO
D I G I TA L
F E AT U R E
Glorious news for cheese connoisseurs – possibly OPINION PH AR
r 2017O. UK .C embe Sept M AF IE LD
STPs scrutinised and new models of care discussed F E AT U R E
PH
K 017 er 2 .C O .U emb E L D Dec R M A FI
A
03 07 08 12 14 16 18 22 23 24 26 29 30 31
N E WS
Is being overweight the epidemic of our times?
October 2017
PHA RMA
FI E LD.C O.U
7 October 201LD.C O.U K PHA RMA
K
FI E
P F AWA R D S
The magical transformation that occurs after winning T WO TA K E S
Opinion battle over the privatisation of our NHS OPINION
To request a FREE print subscription for your workplace, or to sign up to our weekly newsletters for the essential headlines, Jobs of the Week, PharmaTalent and thought-provoking features, visit pharmafield.co.uk/subscribe This issue and all past issues of Pf Magazine can be viewed online at issuu.com/pfmagazine
Martin Moth on the role of patients in digital
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P f N E WS : B R IN G IN G YOU TH I S M O NTH ' S E SS ENTI A L H E A D LIN E S
EMA
GOING DUTCH The European Union’s (EU) General Affairs Council has voted for Amsterdam to become the new home for the European Medicines Agency (EMA). The Dutch city, which replaces London, beat competition from countries including Athens, Copenhagen, Dublin, Helsinki, Stockholm and Warsaw. Each bid was assessed on factors of accessibility, schools for children of staff members, healthcare, access to work, geographical spread and an assurance that the agency can still operate in its new home when the UK leaves the EU. Commenting on the Council’s decision, ABPI Chief Executive Mike Thompson said: “We now urge both the UK and the EU to put patients first and acknowledge that securing a comprehensive agreement to cooperate on medicines safety, regulation and supply is an urgent negotiating priority.” John Hardy, Professor of Neuroscience at University College London, said: “Of itself, it is bad enough news – many highly skilled jobs moving out of the country. But a greater impact will be the tug this exerts on the pharmaceutical companies as they weigh up where to make their clinical research investments.”
ASTHMA
Group therapy
N
ew data analysis from the Mundipharma-sponsored REALISE™ (Recognise Asthma and Link to Symptoms and Experiences) survey has identified different patient groups sharing common attitudes towards asthma and its management. Published in the Journal of Allergy and Clinical Immunology: In Practice, it found five clusters with differing levels, particularly in areas such as asthma control, and use of reliever medication. The results of the online study also indicate that patients have different needs
Pf View: The irony of moving to a city already famous for a different drug culture will not have been lost on pharma companies. Amsterdam, however, is such a metropolis of free-thinking that hosting the EMA could yield an exciting new era of alternative approaches.
and may require distinct approaches during consultations in order to better manage their asthma. It showed that people with asthma are still experiencing largely preventable symptoms that disrupt their daily lives. Professor David Price, co-author of the REALISE™ publication, Chair of Primary Care Respiratory Medicine at the University of Aberdeen, said: “This cluster analysis has identified important patient attitudinal subgroups. HCPs will need to engage effectively with each type of patient to improve overall management of their disease.”
M AG A ZI N E | JA N UA RY 2018 | 3
DIABETES
WEIGHT IS OVER
A
landmark trial funded by Diabetes UK has shown that it is possible to send type 2 diabetes into remission using an intensive 800kcal-a-day weight management programme. The trial, DiRECT (Diabetes Remission Clinical Trial), is a two-year study aimed at finding an effective and accessible way to proactively treat the condition. The trial used the Counterweight Plus weight management programme supplied by Cambridge Weight Plan.
The results showed that almost half (45.6%) of those taking part were in remission after 12 months, and nine out of 10 participants who lost more than 15kg also placed their condition into remission. Meanwhile, over half (57%) of those who lost 10 to 15kg achieved remission, along with a third (34%) who lost five to 10kg. Only 4% of the control group achieved remission. The first-year findings of the study suggest that type 2 diabetes remission is closely linked to significant weight loss. Diabetes UK has so far committed £2.5million to DiRECT, with a further £300,000 added recently. Pf View: This is a great opportunity for type 2 diabetes patients. It will be fascinating to see how motivated they are to see off their condition and whether it will eventually translate to fewer hospital visits and doctor appointments.
PA R T N E R S H I P S
Hang out with Guy’s Johnson & Johnson Managed Services and Guy’s and St Thomas’ NHS Foundation Trust, have announced a new 15-year partnership to deliver an Orthopaedics Centre of Excellence at Guy’s Hospital. The partnership is designed to optimise the standard of care for orthopaedic patients by addressing the challenges highlighted by Lord Carter and Professor Briggs, while implementing some of the key recommendations outlined in their reports. As part of the managed services agreement, the orthopaedics centre at Guy’s Hospital will be expanded and redeveloped, meaning more patients will have access to services. Plans include the development of an additional operating theatre in year one and eight new state-of-the-art theatres by the end of year three. This centre of excellence will also provide a hub for education and training, and offer a dedicated space to facilitate leading-edge research to improve clinical outcomes for patients. Mr Peter Earnshaw, Clinical Director of Surgery at Guy’s and St Thomas’ NHS Foundation Trust, said: “The partnership will further increase the time that frontline clinicians can focus on patient care and enable us to identify opportunities to improve the supply chain.”
Quick doses B M S announces EMA validation of its type II variation which seeks to expand indications for Opdivo plus Yervoy to include other patients with advanced renal cell carcinoma. • EC approves a new indication for A S TR A Z E N E C A’s Faslodex in combination with palbociclib, for treatment of epidermal growth factor receptor 2 negative or metastatic breast cancer.
B E N E VO L E NTA I , in partnership with the A S S O C I ATI O N O F MEDICAL RESEARCH C H A R ITI E S , has launched the BenevolentAI Award, to help charities accelerate their medical research. • JA N S S E N ’s Tremfya is now available in the UK for adults with moderate to severe plaque psoriasis who are candidates for systemic therapy.
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A DV I C E N N E publishes positive six months follow-up data from pivotal phase III study assessing ADV7103 in adults and children suffering from distal Renal Tubular Acidosis. • A head-to-head study shows S A N O F I ' S Toujeo and N OVO N O R D I S K ' S Tresiba similarly lower blood glucose levels in adult diabetes patients.
P f N E WS : B R IN G IN G YOU TH I S M O NTH ' S E SS ENTI A L H E A D LIN E S NHS
Change gear DEMENTIA .
TAKE A VOW
M
arriage may lower the risk of developing dementia, according to new findings. The study, published in the Journal of Neurology Neurosurgery & Psychiatry, combined the results of 15 studies, including data on over 800,000 participants. The results showed that people who remain single are at a 42% greater risk of developing dementia than people who are married, while widowers were 20% more likely to develop the condition. There was no difference in the risk of dementia between those who were married and divorced. The researchers suggest that part of the risk may be explained by poorer physical health among lifelong single people, and that marriage may help both partners to have healthier lifestyles, including exercising more, eating better, not smoking and drinking less. Dr James Pickett, Head of Research at Alzheimer’s Society, said: “As this research combines evidence from 15 different studies, we can be more confident in the conclusion that married people, on average, have a reduced risk of dementia compared to those who are single.”
M E N TA L H E A LT H
#mentalhealth trending
N
HS Digital has published statistics on young people who have been referred for treatment or assessment with mental health services in England. According to figures in the Mental Health Bulletin 2016-17, out of all young people, 16- to 17-year-old females were most likely to have had an open referral with mental health and learning disabilities services. 11% (69,000) of 16- to 17-year-old females in England are known to have had an open referral with NHS-funded secondary mental health, learning disabilities or autism services during 2016/17. In addition, 2% (1300) of the group were admitted to hospital as part of their referral. During the same period, 8% of 16 to 17-year-old males (52,000) in England are known to have had an open referral with these services. In total, more than 2.6 million people are known to have had an open referral with mental health services during the year. 560,000 of these were under 18, meaning that 5% of people in England will have had an open referral with secondary mental health, learning disabilities and autism services during 2016/17.
NHS England (NHSE) has launched a consultation to simplify and standardise the process for getting research projects up and running across the NHS. Cuts to bureaucracy and faster access to new and innovative treatments are at the heart of 12 actions agreed by the NHSE Board to support research, and how it is applied, in the NHS. A common obstacle to research is management of excess treatment costs, which often arise from conducting research in the NHS. Changes have been proposed to the processes associated with this, including for specialist services. NHSE is also consulting on ways to further improve the commercial clinical research set-up; seeking to eliminate delays for research studies conducted across multiple sites by standardising processes. Peter Ellingworth, Chief Executive of The Association of British Healthcare Industries, said: “The NHS has the potential to be the best test bed for new medical technologies anywhere in the world. We welcome this initiative and the recognition from NHS England that we need to simplify the landscape for the introduction of such technologies.”
CLINICAL TRIALS
Joined up thinking AbbVie has revealed that the Phase III iNNOVATE trial evaluating IMBRUVICA® (ibrutinib) combined with rituximab, in patients with previously-treated Waldenström’s macroglobulinemia, met its primary endpoint. The therapy successfully demonstrated improvement of progression-free survival compared to rituximab alone. The Independent Data Monitoring Committee recommended that the study should be unblinded based on the positive outcome from the pre-specified interim analysis data. IMBRUVICA, a first-in-class Bruton’s tyrosine kinase inhibitor, is jointly developed and commercialised by Pharmacyclics LLC, an AbbVie company, and Janssen Biotech. Pharmacyclics and Janssen are planning to share the interim analysis data from the study with regulatory authorities, while presenting the data in due course.
M AG A ZI N E | JA N UA RY 2018 | 5
P f N E WS : B R IN G IN G YOU TH I S M O NTH ' S E SS ENTI A L H E A D LIN E S
BREXIT
Brexit sign The European Medicines Agency (EMA) has published additional guidance to help pharmaceutical companies prepare for Brexit. The guidance document sets out the practical and simplified requirements that companies should follow when they apply for changes to their marketing authorisation, while allowing for the continued marketing of products in the European Economic Area post-Brexit. The guidance has been prepared on the basis that the UK will separate from the EU as of 30 March 2019. The EMA says that marketing authorisation holders, applicants and sponsors of centrally authorised medicines should consider how Brexit will impact their medicines and which changes must be addressed before Brexit occurs. Pharma companies have also been advised to make sure that any necessary changes are made prior to the date of withdrawal. The EMA is now creating further Brexit guidance which will be published on its website in due course.
DIABETES
Man, that’s not good
Pf View: Providing briefing documents is clearly a sensible strategy by the EMA, but surely pharma companies have already got specifically assigned and mission-ready Brexit teams keeping their eyes fixed on the situation as it unfolds?
A
report from the Men’s Health Forum reveals that men are more likely to develop diabetes than women, and are more prone to experience life-changing or even life-ending consequences. The Men’s Health Forum’s new report ‘One In Ten: The Male Diabetes Crisis’ shows that men are 26% more likely to develop type 2 diabetes than women, and are more likely to be overweight and develop diabetes at a lower BMI than women. They are also less likely to be aware that they are overweight or participate in weight management programmes. Furthermore, men have a greater chance of suffering from diabetic retinopathy,
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developing foot ulcers, having a foot amputated or dying prematurely, as a result of diabetes. The report emphasises how the sex inequalities have not been highlighted by health policy makers and argues that the National Diabetes Prevention Programme must be designed and delivered in ways that work for men. Martin Tod, Chief Executive of the Men’s Health Forum, said: “The Men’s Health Forum wants to see a serious programme of research and investment to ensure men get the support and care they need to prevent and manage diabetes.”
1.
HIGH FIVES
E M IS SIONS T E ST The choice of anaesthetic gas is a significant contributor to emissions, according to the first study measuring the carbon footprint of surgery. The analysis took place at the surgical suites of three hospitals in the UK, US and Canada, demonstrating that the type of anaesthetic gases used in surgery can be a major contributor to greenhouse gas emissions from operating theatres. Emissions due to anaesthetic gases accounted for approximately 2000 tonnes of CO2 equivalents at each North American site, which was 10 times higher than the anaesthetic gas emissions from the John Radcliffe Hospital in Oxford, UK. Authors say the higher usage of desflurane in Canada and the US is responsible for the higher emission there.
2.
K NO C KOU T DE A L AstraZeneca has completed a commercialisation agreement with Aspen Global Incorporated (AGI), part of the Aspen Group, under which AGI will have the residual rights to established anaesthetic medicines comprising of Diprivan, EMLA, Xylocaine/Xylocard/Xyloproct, Marcaine, Naropin, Carbocaine and Citanest. Under the terms of the new agreement, AGI acquired the remaining rights to the intellectual property and manufacturing know-how related to the anaesthetic medicines.
3.
T IC K E D OF F A study by NHS Improvement claims that operating theatres in England are ‘wasting two hours a day’. An analysis of operating theatres across 100 NHS trusts in England found that over two hours each day were wasted on the average procedure list. The time was lost on avoidable factors such as late starts for operations which had been planned in advance. The study found that around 280,000 additional non-emergency operations could be carried out yearly if NHS schedules were better organised, with fewer late starts, rather than making surgeons work harder.
V I RT UA L A S SISTA NC E
IN SURGERY
High fives: operating theatres dissected
4. WORDS BY
A new intake of trainee surgeons in Scotland is taking part in a UK-wide pilot scheme which uses the simulation of an operating theatre to hone their surgical skills. The ‘Improving Surgical Training’ programme is described as being similar to a boot camp and aims to simulate using a range of techniques, from working on cadavers to virtual reality operations. Nine Schools of Surgery and Training Boards throughout the UK will be used as pilot sites.
5.
Amy Schofield
H A PPY FO O T-AG E A study has revealed that children scheduled to undergo surgery experienced reduced preoperative anxiety after taking part in a Virtual Reality (VR) tour of the operating theatre prior to anaesthesia. 69 suitable children were randomised into a control or VR group. The control group received conventional education, while the virtual reality group watched a four-minute VR video showing 'Pororo' the little penguin visiting the operating room and explaining what happened there. Children in the VR group had a much lower m-YPAS score – used to assess preoperative anxiety – than those in the control group.
M AG A ZI N E | JA N UA RY 2018 | 7
WORDS BY
Amy Schofield I L L U S T R AT I O N B Y
Alex Buccheri
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COVER STORY
Our industry experts predicted a number of challenges and opportunities facing pharma and healthcare in 2017, but what does the forecast hold for 2018?
EXPERT PANEL
S TE V E H O P K I N S O N Commercial Director, Immunology Products Division, AbbVie UK
JESS FINE Executive Director, External Affairs, MSD
C H R I S M O L LOY CEO, Medicines Discovery Catapult
JA N E D E V E N I S H NHS Standards and Services Pharmacist, Well Pharmacy
S A M I R PAU L Director, Inicio Consulting
JENNIFER LEE Director of Health Economics, Market Access, Reimbursement & Advocacy, Janssen UK
JEAN-MARIE AU L N E T TE Vice President of EMEA sales, TraceLink
C A R LO S M AC H A D O Serialisation Director, SEA Vision US
M AG A ZI N E | JA N UA RY 2018 | 9
“ There remain many challenges in relation to patient access to medicines”
PATI E NTS FI RST
CHALLE N G E S
S TE V E H O P K I N S O N : The challenge for our industry to keep improving the standard of care, while offering value, will remain important in 2018. It is a challenge AbbVie is well placed to rise to. In several of our fields, particularly auto-immune conditions and oncology, this will be the year where we start to see treatments that can fill unmet needs become a reality for patients. J E S S F I N E : Although the UK has a world class science base, there remain many challenges in relation to patient access to medicines and the wider commercial landscape. This is hindering the creation of a more competitive environment in which to drive investment, jobs and growth for the future. We welcome the Government’s Industrial Strategy which offers the opportunity to deliver a stable and holistic approach to life sciences that recognises the full value of innovative medicines from early stage research all the way through to adoption. J E A N - M A R I E AU L N E T TE : The biggest challenge the pharma industry faces is realising the full complexity and resources needed to meet the requirements of the EU’s Falsified Medicines Directive (FMD). The often-overlooked reality is the complexity of implementing an FMD-compliant solution that needs to transfer data from manufacturers and regional hubs, to the EU hub.
S TE V E H O P K I N S O N : We have learnt a huge amount to optimise care and prove value through collecting the right data. We measure the service we provide and give de-identified data to the treatment centres, so they can better understand what’s happening with their patients along their treatment journey. We also use a patient experience reporting tool to capture satisfaction feedback on the support programme. If these approaches can be widely adopted across the system and industry in 2018, then we stand the best chance of efficiently improving lives of patients. JENNIFER LEE: To drive sustained innovation in early diagnosis and development of precision medicines, the Government needs to invest, not only across the spectrum of R&D – from bench research to developing new clinical interventions – but also in rapidly adopting new innovations in the NHS. This will enable new treatments and technologies to reach UK patients. Success hinges on collaboration between the global life sciences industry, the public sector and Government, harnessing the ability to pool expertise. Partnerships are a fundamental aspect of our business, and we’re continually seeking new opportunities to improve outcomes for patients.
THE BREXIT EFFECT
“The post-Brexit world does give the UK potential to carve a new distinct role for itself” J E S S F I N E : We believe this country can be well-placed to lead the world in delivering high-quality care for patients. To meet this ambition, however, it is essential that we address some very real concerns relating to the potential impact of the UK’s exit from the EU for our supply chain, regulatory environment and ability to attract talent to the UK. Ensuring UK regulatory alignment with the EU is essential to ensuring patient access to medicines is not disrupted.
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C H R I S M O L LOY: Clearly the major impact of Brexit remains uncertain. We need to calmly look beyond; to the reality of a regional change within a global industry. As innovators we need to look for the opportunities change brings. The quality of the UK’s MHRA has traditionally had a strong influence on European Medicines Regulation and I do not see that stopping. While the UK will be outside the EU, the industry and the expert opinion remains in the UK, and biology knows no borders. I am confident that the transition will be managed and that both organisations will continue to collaborate closely in developing regional opinions and best practice. The post-Brexit world does give the UK the potential to carve a distinct role for itself in discovery and early clinical development.
J E N N I F E R L E E : The UK is a global leader in life sciences, so a transition period is vital to enable businesses to adapt to the new operating environment. The uncertainty surrounding Brexit raises concerns over a range of subjects such as trade and supply, medicines regulation, access to talent, research and collaboration, clinical trials, and access of patients in the UK to medical innovation. We have welcomed the opportunity to participate in the BEIS Committee’s ongoing pharmaceuticals inquiry on Brexit and the implications for UK business, and are working with the industry and Government to seek resolution over issues critical to the UK industry and economy, health services, and above all, patients in the UK.
COVER STORY
DIGITAL “ The movement towards personalised medicines is picking up pace as we head into 2018” J E S S F I N E : The NHS has made digital excellence the cornerstone of its future model and we must embrace this if we are to have a healthcare system fit for the 21st Century. As a company, we are deeply committed to scientific discovery, working in partnership with the healthcare system and scaling innovation through a number of NHS partnership projects, such as Velocity Health and the Test Beds programme.
S TE V E H O P K I N S O N : There are interesting developments in changing the way healthcare is delivered through digital enablement and supported self-management that could really go mainstream in 2018. Patient access to online educational resources, which encourage greater knowledge of an individual’s condition and support their self-management, is a vital role industry can play. AbbVie already does this, providing one-on-one guidance, and face-to-face or telephone support. This ensures patients have the confidence to use medicines correctly and get the best possible outcome. 2018 will see us make further improvements to these programmes, which we believe offer best value for the health service and patients.
C A R LO S M ACO : The movement towards personalised medicines is picking up pace as we head into 2018. New digital technologies are amplifying this shift from large batch manufacturing to smaller personalised batches. By using newly accessible data, companies can connect genetic information with real world data, such as lifestyle and wellness metrics, to provide a combined drugs solution. The effect on industry is a shift in its manufacturing focus, as some move away from a stock-based model to one that is made-to-order based.
O PP O RTU N ITI E S FO R I N D USTRY C H R I S M O L LOY : Times of change and challenge yield great invention, and bring otherwise fragmented organisations together to gang up on the problem. The UK is already a leader in clinical cohort experimentation and discovered 25% of the world’s top 100 medicines. By structuring investment partnerships focussed on innovative opportunities, the UK has immense potential to be harnessed through translational centres like the Medicines Discovery Catapult to create national pipelines of new ideas that move into the clinic. We can harness connected data at scale and create new public-private partnerships that will support new drug R&D centred around the many disease charities who are ready to translate clear patient need into new medicines and crystallise innovative new sources of funding. I believe that the UK is ready to pull together in response to Brexit, embracing the opportunities that lie ahead. S A M I R PAU L : I genuinely believe there are two things that will become more critical in 2018. Our ability to engage with patients more, thereby increasing the chance of commercial success and, secondly, how we use digital technology, including data and analytics, to get closer to the patient, treatment needs and creating appropriate healthcare solutions.
CO M M U N IT Y PHARMACY JA N E D E V E N I S H : The role and scope of pharmacists is rapidly changing, and the landscape for community pharmacy will continue to change in 2018. Our pharmacists play a crucial role in ensuring that people have the medicines and information they need to look after their health. We are working in collaboration with the wider health service and other pharmacy multiples to ensure this moves forward in 2018.
“ Times of change and challenge yield great invention” M AG A ZI N E | JA N UA RY 2018 | 1 1
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OPINION
Commission accomplished? A landscape that once stood on the precipice of functionality has since become a treacherous maze.
I
have a useful ‘pivot table’ listing the 209 CCGs and their 140 Chief Officers, some of whom head up five or more CCGs. These numbers reduce weekly. There were originally 303 PCTs in 2001, then 152, before being grouped as 49 PCT ‘clusters’, via a process of appointing shared managers across what were, technically, separate entities. Fifteen years ago, I worked in the first PCT cluster – a de facto merger of three PCTs. Indeed, we used to have board meetings with three logos on the bottom of the page. This was a clever idea; effectively, a merger of statutory bodies which negated legislation, reduced management costs (slightly) and made the most of managerial ability. PCT clusters were compulsory from 2011, with financial and waiting time target performances evened out on a geographical basis, meaning that groups of under-spent and over-spent PCTs could be linked to achieve one balanced budget. I was one of the first managers trained for the world of ‘purchaser-provider splits’ in 1991, and moved to commissioning because I truly believed in a future of planning, health economics, evidence-based protocols and care pathways measured against specification. I subsequently worked on the ‘PCT Fitness for Purpose’ programme, which led on to the World Class Commissioning concept initiated exactly 10 years ago. We talked about higher qualifications in NHS commissioning, and the possibility of clinicians joining the commissioning melting pot. That seems utterly laughable now. For 25 years too many PCTs and CCGs have simply been temporary piggy banks, used to pass money directly to providers. Meanwhile, as others have engaged in blame exchanges, dressed up as contracting, only a few have delivered things that actually benefit patients. Through all of that, we have endured tenders, endless meetings, finance transaction costs and the disheartening culture of intelligent people being distracted from improving real healthcare.
WORDS BY
David Thorne
Commissioning failed because the constituency of support wasn’t there. The public never got it and therefore commissioners had no mandate, whereas the providers never lost that endorsement because ‘it came with the stethoscope’. Repeated re-organisation has destroyed even the faintest chance of commissioning being scientific, professional and sophisticated. Putting public health into local councils was the final straw, with GPs unable to influence accountant-led CCGs. I think CCGs will consolidate to SHA size with primary care home hubs designing local pathways using devolved budgets. The internal market will wither away and be replaced by integrated health economy planning – so a bit like Scotland and Wales, but with provider performance scrutiny. No doubt you lot are ready for this and what it means for your company, products and role. If so, believe me, you’re ahead of the NHS! David Thorne is Chair, Washington Community Healthcare and Non-Executive Director, City and Vale GP Alliance. Go to blueriverconsulting.co.uk
CENTRAL CHARACTERS CCG s – Clinical Commissioning Groups replaced PCTs during a restructure five years ago. P CTs – Primary Care Trusts were responsible for NHS commissioning between 2001-2013. S H A – Strategic Health Authorities led the development of local health services. Closed in 2013. P I VOT TA B L E – Jewel in the Microsoft Excel crown, this enables users to extract sense from a seemingly mind-boggling data set.
M AG A ZI N E | JA N UA RY 2018 | 13
COFFEE BRE AK
Green cross crusade Dr Zubair Ahmed had always pledged to help as many people as possible while also bringing GPs and pharmacists closer together. INTERVIEW BY
M
y guest today has taken his dream of fusing the best aspects of general practice with the exciting digital healthcare ecosystem, and planted it straight into our neighbourhoods. It’s a pharmacy experience, but not as we know it. Hi Zubair, what’s your story? I’m from Glasgow, went to medical school in Aberdeen and did my GP training near Newcastle. Once qualified, I returned to Glasgow and settled into life as a GP. During those five years, I decided that, instead of helping 30-40 people every day, I wanted to help thousands. What inspired the change of direction? I realised that online appointments were potentially very convenient, but didn’t think that a purely online service was safe for everyone, as there are many important conditions that wouldn’t be possible to diagnose without direct clinical assistance. Therefore, I had the idea of combining the best aspects of online and offline medicine – a hybrid model. How did you go about realising your ambition? While I was a doctor, I also did an MBA at London Business School, and that’s when the concept grew. With lots of help from professors, fellow students and mentors, I founded MedicSpot. The company operates out of the school on Baker Street, and we work with independent pharmacies, across 10 cities in the UK, using our technology to convert them into online GP surgeries.
1 4 | PH A R M A FI EL D.CO.U K
John Pinching
Why pharmacists in particular? One of my friends had his own independent group of pharmacies in Scotland and he complained that he was fitting out consultancy rooms, and they would never get used. With the MedicSpot facility, pharmacists, who have historically been underused healthcare professionals, can use their clinical expertise to identify a problem, before potentially referring patients to a virtual GP. How does the conversion to a virtual GP surgery take place? MedicSpot installs a computer, attached to which is a variety of diagnostic equipment, in the consultation room. This ‘station’ then allows the pharmacy to offer private GP consultations directly from the premises. We’re now seeing patients on a daily basis and the feedback from patients, pharmacists and doctors has been very positive. What will the patient experience involve? Once connected to one of our doctors, the GPs then ‘examines’ the patient using the stethoscope, blood pressure machine, otoscope, pulse oximeter or thermometer. If needed, the doctor will send an electronic prescription which, of course, can be dispensed on site at the same pharmacy. From opening the door, to picking up medicine, everything can happen in 25 minutes, eliminating all that faffing around when you’re trying to find a chemist after work. After all, you’re already there! What impact could this have on public health? It’s going to help the NHS by relieving some of the burden. Tourists, for
example, would typically access healthcare through a GP and much of the time the NHS doesn’t have the facility to extract payment from them. Instead of turning up at accident and emergency, where it costs up to £150 for every patient, they are using our service. How have doctors become involved? We have doctors on our panel throughout the UK. They’re generally NHS GPs and they work for us one to two days a week. The average GP only works for the NHS 3.7 days a
week, so they’ve got 1.3 days when they’re not working. With MedicSpot they’ve got an opportunity to work from home, instead of a clinic, enabling us to deliver more appointments in the process. One of our doctors started working for us when she was on maternity leave – if she hadn’t done that all her expertise would have been wasted for six months.
“From opening the door, to picking up medicine, everything can happen in 25 minutes, eliminating all that faffing around when you’re trying to find a chemist”
Is this the future of high street healthcare? Customers, patients and the public are crying out for convenience, but healthcare is generally inconvenient; it’s too fragmented. Providers need to think seriously about how to engage with patients more. Clearly this is an area where pharmacies can really help. We already have these bricks and mortar high street locations, we have well-trained clinical staff on site and we have fast, accurate technology. In five years’ time it’s possible that people who would once have gone to hospital for routine tests and appointments, will go to the pharmacy instead. Are you one of the network of MedicSpot docs? Yes, I do MedicSpot shifts quite regularly. It’s good to set an example and keep your ear to the ground, while learning about why patients are using the service. We’ve had patients who are 70 years old, who don’t even have an email address, but because of the interaction with a pharmacist, they’ve been able to have remote appointments. What happens in terms of documentation? If patients want it they will receive an electronic copy of the consultation records, while their regular GP will also be provided with the relevant documents. It’s important to maintain continuity of care. For instance, if we prescribe salbutamol for a patient with asthma, it’s good practice to inform their regular GP.
vision We strive for global leadership in
psychiatry neurology
and
by improving the lives of patients
key disease areas
depression
alzheimer’s disease
parkinson’s disease
schizophrenia
our principles
focused, passionate responsible We are
and
What one record would you choose for the soundtrack of your life? The Forrest Gump soundtrack. The entire album? Sure! It’s your last supper, what are you having? Pizza and chips. Just what the doctor ordered. Goodbye Zubair. Bye John. Go to medicspot.co.uk
www.lundbeck.com/uk UK-NOTPR-0002
Date of preparation: December 2017
M AG A ZI N E | JA N UA RY 2018 | 15
“ Hot on the heels of the Government’s new industrial strategy, it is a resounding recognition of pharma and medtech’s status as a true asset for Britain”
Big deal What does the new agreement for the life sciences sector actually mean?
T WORDS BY
Claudia Rubin
16 | PH A R M A FI EL D.CO.U K
he UK has a huge amount to offer the life sciences sector. It combines globally renowned scientific research bases with a world leading NHS, which allows innovators to test and refine products at scale. “Life science organisations of all sizes will continue to grow and thrive in the coming years, which means NHS patients will continue to be at the front of the queue for new treatments,” according to Jeremy Hunt in the official publication of the ‘Life Sciences Sector Deal’, announced in early December. The key point for healthcare is in his last phrase; do the truisms of the first part automatically deliver the latter pledge? The ambition for patient benefits, in reality, seems to bear little relation to the actual content of the document. A flurry of newsworthy investment deals announced in quick succession ensured that the deal gained significant press coverage. Hot on the heels of the Government’s new industrial strategy, it is a resounding recognition of pharma and medtech’s status as a true asset for Britain.
INDUSTRIAL STRENGTH: B E L L R I N G S FO R I N N OVAT I O N
The Life Sciences Sector Deal was pitched as a realisation of the recommendations from Sir John Bell’s life sciences industrial strategy. It reflects the joint strategic vision of Government and industry for Britain to continue hosting worldleading medical research, and the discovery of innovative technologies and breakthrough treatments. It is also about giving businesses a boost, creating jobs and advancing the UK economy. When measured against those latter aims, this sector deal is unquestionably a success, although the extent to which it delivers on the Bell review remains to be seen. With the industrial strategy agenda very much ‘owned’ by the Prime Minister and the sector deals sitting squarely with the Department for Business, Energy and Industrial Strategy (BEIS), a lot more thinking is required if these commitments are to translate into benefits for patients and the NHS.
POLITICS
INDUSTRIAL STRATEGY November 2017
LIFE SCIENCES I N D U S TR I A L S TR ATE GY August 2017 • HARP • Emphasis on leveraging data available through NHS (regional Data Innovation Hubs) • National Data Guardian • Emphasis on linking Government, industry and the NHS
• Investment of £725m in new Industrial Strategy Challenge Fund (ISCF) for four Grand Challenges • Provide £210m to enhance data for early diagnosis and precision medicine • £115m ‘Strength in Places’ Fund with 25 Science & Innovation Audit Themes • MSD to establish UK Discovery Centre
AU T U M N B U D G E T October 2017 • Increase R&D tax rate from 11% to 12% • Raise total R&D investment to 2.4% of GDP by 2027 • £12.5bn public investment in R&D in 2020/21 • Drive £20bn investment in innovation/high potential business • Invest £406m in STEM skills
L I F E S C I E N C E S S E C TO R D E A L December 2017 • 100,000 Genomes Project with GSK and AstraZeneca • £146m investment programme from Industrial Strategy Challenge Fund to grow medicines manufacturing • Investment in innovative clinical trial platforms (£950m in next 5 years) • £16m ISCF funding for viral vectors competition • £350m investment in the Leeds City medtech hub
D
espite the deal being officially signed off by both the Secretaries of State at the BEIS and DH, it has no presence on the Department of Health website, and we’ve heard nothing from them or Jeremy Hunt – not so much as a tweet – on the subject. Coverage of it is largely absent among typical health publications, with only the business pages covering the biggest deals, such as those with GSK and Merck. It is, however, presented as being good for patients; the deal’s foreword claims, ‘these investments…will also produce real benefits for patients – through allowing earlier diagnosis of conditions and speeding up access to new treatments.’ Bell’s proposals for building the strengths of the life sciences sector were organised into five key themes – science, growth, NHS, data and skills, and of these, it is the NHS that seems to have been largely overlooked. Healthy scepticism is also required as to whether the data section in the deal offers any new solutions to some fundamental issues with patient information. The commitment to Digital Innovation Hubs and investment in the extension of the Genome Project at least sets out some practical ambition. But
the paper falls well short of how UK-based R&D will facilitate better NHS access to new technologies and, given that there will surely be an expectation of some healthy returns on their investments, it may be that companies will need to look first to the global market. Some might say that the Accelerated Access Review (AAR), and the Government’s recent response to it, is the missing piece of the jigsaw, and with the brief mention of the Accelerated Access Collaborative in the deal, it appears this policy intends to provide NHS patients with access to the fruits of this advanced research carried out in Britain. Given the weaknesses of the proposed Accelerated Access Pathway, evident in the impact assessment published last month, the idea that the sector deal may depend wholly on the AAR to ensure a beneficial impact for patients is concerning. With so little health profile given to a cross-departmental document which is, it seems, entirely accountable to BEIS, it is likely that the healthcare aspect will be further diluted in the face of BEIS’s differing agenda. A key criteria of the entire industrial strategy was to embrace the UK as a whole, and this sector deal is at pains to demonstrate this
through the geographic spread of various R&D sites. One could argue, however, that for the UK as a whole to really benefit, it would have to elaborate on how R&D infrastructure translates directly into patient benefit. There is unfortunately little by way of explanation or new initiatives that explain how this will be so. Progress in the overall governance arrangements will be key; which stakeholders will be represented on the deal’s Implementation Board for its first meeting, in early 2018, will determine the likelihood of success, and whether it will continue to be skewed so heavily towards a business agenda over and above healthcare. As such, there is a massive amount of work to be done to convert commitments for a strengthened research environment into opportunities that ensure industry energy and investment become widely accessible to patients in the coming years. The Government will inevitably lay itself open to criticism of a big business, elitist agenda if UK patients fail to find themselves at the front of the queue when cutting edge UK science is converted into medicine. Claudia is a Director at Decideum. Go to decideum.com
M AG A ZI N E | JA N UA RY 2018 | 17
MARKETING
MOVING ON Old sales techniques are being confined to history and survivors must look at new horizons. WORDS BY
Dr Graham Leask
The sales dilemma
Figure 1.
ACCOUNT GROWTH ACCOUNT DEVELOPMENT Practice focus (Account growth)
?
Practice coverage Seeing more practices but fewer customers (Account development)
• A ssumes GPs act as individuals • Key focus achieving maximum sales from each practice
•A ssumes that GPs in a practice largely follow protocol •H igh value practices key focus
100 90 80 70 60 50 40 30 20 10 0
Total time (percentage)
Sales force time allocation
27 6 21 8
3
30 11 5
4
2
13
7 6
NON-SELLING TIME
18 | PH A R M A FI EL D.CO.U K
SELLING TIME
Figure 2.
Travel Other Admin Pricing Customer service Planning Selling Prospecting Relationship building Training Selling face-to-face By customer By product
D
espite all the rhetoric about multichannel marketing, patient centricity and the inexorable rise of digital, the most effective sales channel is still standing ‘two feet in front of the doctor’. This is not to say that digital isn’t useful, but too frequently, while the costs of digital activity appear low, the actual economic return in cash terms can be disappointing. The reason is twofold. Firstly, most digital activities cost a small fraction of traditional methods. Secondly, when people talk about digital they often mean different things. With an acceptance that ‘people prefer to buy from people’, the traditional sales model is, however, coming under economic scrutiny. Today, healthcare professionals are under time and budget pressure. As a result, their degree of freedom to engage with representatives and adopt new products is curtailed. This has spawned variants, from key account management to service representatives but, ultimately, the underlying economics remain largely unchanged. There are a number of ways in which the average sales team can work more effectively. Note effectively, not efficiently. To quote the American management scholar Peter Drucker, “efficiency is doing things right, while effectiveness is doing the right things”. The key to effective selling is a concentrated effort on the right activities, directed at the right people. This is in contrast to the control and command model pursued by many companies which focuses on call rate, coverage and frequency. It is also at odds with the rather laissez faire view that each representative runs their own business and makes their own unilateral decisions. Both approaches are wasteful for different reasons. At one end of this spectrum we have a highly mechanistic tight control model that stifles creativity and racks up massive wastage as representatives, pressured to meet quotas, pile up calls at ineffective frequencies on ‘soft’ customers. At the other end, management abdication may lead to a lack of message consistency between adjacent geographies.
A Q U E S TI O N O F PRO G R E S S A more productive approach is to carefully consider the structural and economic distribution of therapy sales on your territory. By structure I mean the type of organisations and how you approach them. One key structural break is between hospitals and GP practices. What do the referral patterns look like in your territory and which hospital specialists are ultimately supporting, influencing or driving demand? Secondly, how are prescriptions filled and which pharmacies service the bulk of your key practice prescriptions? Thirdly what is the mix of dispensing and nondispensing practices? Finally, how are sales distributed by practice size? Unless we understand this web of relations, optimal management is illusory. The above questions are some that I would expect answers to within a territory business plan. For ease I use the example of primary care, but this argument may also apply to hospital departments. The key to understanding is sound, well-organised local knowledge. Your local territory manager should have this at their fingertips. Forget the standard set of dashboard charts which frequently act to distract and obfuscate the truth – take a lesson from Lord Alan Sugar and follow the money. A sound understanding of sales economics is key to success. Recently GSK announced that it has abandoned individual sales incentives and focused on rewarding the right inputs. The question is, which are they? Do we view a practice as a body of healthcare professionals and relevant support workers? Alternatively, do we see a nominated contact or contacts within a given surgery, thus allowing us to cover more surgeries? See figure 1.
Do we see dispensing doctors as a rural relic? Or, perhaps, we recognise that with a considered approach you can win a much greater market share within these practices, and that some have tremendous potential to influence? Furthermore, what is the annual value of each practice in cash terms, divided by the cost of servicing that account? What generally drives local sales is the recognition that every sales person has restricted time and making the right choices is critical to driving results. These choices are not made in a vacuum, however, so the local environment will strongly influence the effectiveness of alternatives. These differences are not individual, and examining a sales force generally reveals several different field force strategies. Here, sound analysis can identify an ‘optimal’ way of working that may be far more effective. Identifying these strategies and adopting a learning approach will allow your field team to keep pace with their environment and maximise return. In conclusion, in order to maximise sales, it is necessary to understand how sales are distributed and the principle drivers of cash flow. Once we understand where profits accrue we can then focus attention and capitalise upon the opportunity. Beware of cash traps that consume more time and money than they generate. Given the actual proportion of time spent with the customer the simple decisions discussed here can have a big impact. See figure 2. The forward-thinking manager will utilise leading edge analytics to quantify the impact of sales people on each practice, rather than rely on the time-worn techniques that were once the norm. Dr Graham Leask is a consultant and writer on pharma and healthcare. He spent 15 years as a member of the faculty of the Economics and Strategy Group, Aston University.
“ The key to effective selling is a concentrated effort on the right activities, directed at the right people.”
We exist to help people thrive
At Bayer we’re exploring the future and all its possibilities. Our passion for advancing health and nutrition means that the solutions we create today will enrich life tomorrow.
M AG A ZI N E | JA N UA RY 2018 | 19
ADVERTORIAL
2018: A PIVOTAL YEAR FOR OUTSOURCING
Managing Director of Ashfield Commercial and Clinical UK, Colin Watson, talks about meeting changing industry demands, new innovations for a new year and why people power is so vital to future success…
A
new year’s here, so what can we expect from Ashfield in 2018? It’s going to be a really exciting year for us. We’ve had a brilliant 2017; we’re the UK market leader for commercial and patient services and we want to keep it that way. One of the big things on the horizon is the launch of the Salesforce Health Cloud. This will enhance our patient-support programmes by providing a much more personalised, multichannel communication that’ll help patients stay on track with their therapy and get the best outcomes. We’ll also be expanding our medical information service this year and promoting it to more new clients. I’m delighted with the way this service has grown over the last six years. Clients tell us they love it as a flexible and dependable alternative to in-house teams.
One thing we’re seeing more of is clients asking for more flexibility to switch on and off particular services. The popularity of our syndicated and flex nursing teams is proof of this. I believe the natural next step will be the ability for our clients to pulse activity on a shortterm basis. We’re ready to help them with that. The pharma industry is facing many changes and challenges. What does that mean for you? Our clients will always want us to be ahead of the curve, so we have an absolute constant drive to innovate and invest in new services. That’s why we now have such a well-established contact centre, medical information and patient support programme services. There’s real pressure on pharma to operate efficiently and communicate clearly to a very complex customer group,
across multiple channels. We’re passionate about helping them meet that challenge. One approach could be the direct transfer of all current reps (most likely within primary care) to Ashfield. We would then take responsibility for implementing a new model and optimising resources to reflect physician preferences. We’d start this by using analytics to perform segmentation and targeting, enabling increased reach and frequency. The new, more customer-facing model
“ Our clients will always want us to be ahead of the curve, so we have an absolute constant drive to innovate and invest in new services. ”
Ashfield
PF Horizontal Advert.indd 1
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11/12/2017 11:17
might include traditional reps, contact centre reps and patient service teams. For the client, it would mean extended reach at reduced cost, as well as the ability to flex the model frequently and quickly, all the while mitigating risk. It’s just one way we’re looking to provide innovation for our clients. You mentioned a cloud-based service. How has Ashfield engaged with digital to enhance client services? Digital is moving so quickly and it’s a challenge for every single business. But it’s also a massive opportunity. We’re fully embracing digital and exploring all options to see how we can exploit it to provide a more innovative, more efficient, more effective service. For example, our state-of-the-art contact facilities and award-winning e-detailers bring our clients responsive, multichannel services that are proven to grow sales and promote brand awareness. The introduction of Salesforce Health Cloud will allow us to bring that same multichannel approach to our nursing services. We’ll be able to more seamlessly communicate with patients across a host of channels, such as email, text and phone. We’ll also provide self-service tools, such as mobile apps and websites, so patients can track their progress and read support materials on any device. Providing a great service is about more than just technology though. Absolutely. You’ve got to get the foundations right. Our clients trust us to deliver flawlessly at every stage, from the recruitment and retention of the right people for their teams, to project management and reporting. Operational excellence is key. We’re structured to help clients succeed by having the right teams and skillsets to deliver a successful service. Finally, it’s about instilling a culture of not just reporting on results, but working in partnership with the client to be continuously improving. So how would you describe Ashfield’s ethos? Our ethos is to be partners in a client’s success. This means having an indepth understanding of their business and a shared, long-term view of what we want to achieve. As part of this partnership, we’re proactive, agile and responsive. Many of our clients
“ We’re fully embracing digital and exploring all options to see how we can exploit it to provide a more innovative, more efficient, more effective service.”
Ashfield
have worked with us for years and they trust us to deliver a creative, scalable and tailored solution that adds value and, of course, delivers positive outcomes for patients. You said having the right teams in place is important. How do you make sure you’re attracting and retaining the best people in what is a very competitive market? I’ve talked a lot about services and innovative technology, but ultimately it’s about people. We’ve got more than 7,000 colleagues globally, including sales reps, nurses, account managers, medical science liaisons, head office staff and more. Our success depends on them, so we do everything we can to nurture their talents and maximise their potential. We offer things like continuous learning and coaching programmes, and an employee engagement survey, which provides an anonymous forum for staff to give honest feedback on all aspects of working here. There are also lots of opportunities for people to progress in their role or even move into different parts of the business. It’s about giving people the opportunity to thrive in a supportive culture. Our clients frequently say that they enjoy coming to Ashfield House and being part of our collaborative and fun environment. We want our people to be indispensable to our clients, so we’ll always go the extra mile to support, develop and retain employees. Finally, what inspires Ashfield to keep improving and reaching for greater heights? It’s down to our shared values of Quality, Partnership, Ingenuity, Expertise and Energy. They underpin everything and really drive us collectively to be the best we can be. For example, Partnership is all about teamwork and customer focus. One of the ways we live this value is through regular project reviews and our client feedback survey. It’s vital to have processes like these in place so we can listen to clients and strive to do better. Go to ashfieldhealthcare.com/commercial
M AG A ZI N E | JA N UA RY 2018 | 2 1 PF Vertical Advert.indd 1
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OPINION
MIND CRAFT:
Five ways to mental wellbeing
CO N N ECT – engage with people around you and spend time developing those relationships B E ACT I V E – take a walk, go cycling or get involved with sport K EEP G R OW I N G – pick up new skills and increase your learning G I V E TO OT H ER S – even the smallest act can count, whether it’s a smile or a kind word B E M I N D FU L – take in the present moment, including your thoughts, your body and the world around you.
Mental health is everyone’s business After an experience with someone suffering from severe depression, I knew it was time to go on a course.
WORDS BY
Deborah Evans
2 2 | PH A R M A FI EL D.CO.U K
I
n my previous Pf Magazine column, I told you that my knowledge of mental health was not adequate and I had signed up to a mental health first aid course. Here’s what I learned. In addition to identifying discrimination around mental health problems, relating to other people’s experiences, feeling more able to support people and thinking about my own mental health, I have also changed my perspective on mental health. I had previously thought of mental health issues as specific conditions, such as general anxiety disorder, depression, bipolar disorder and schizophrenia, but I now understand mental health to be a continuum – in precisely the same way we define our physical health. Depending on a person’s circumstances, they can have positive mental health, or encounter a less favourable situation, in which they experience symptoms affecting their daily lives and relationships. Furthermore, our mental health changes frequently – we have good days, bad days, indifferent days and dreadful days. There are no absolutes. As with physical health, mental health can vary throughout a person’s life. Someone with a diagnosed mental health condition can have positive mental health, if they are receiving
“ I now understand mental health to be a continuum – in precisely the same way we define our physical health” appropriate treatment, support and care, while a person with no diagnosed mental disorder can have very poor mental health. The goal is to keep above ‘the line’, regardless of whether we have a diagnosis or not. We all have mental health needs and it is estimated that one in six people in the past week has experienced a common mental health problem. Mental health first aid does the same for someone experiencing mental ill health, as first aid does for physical injuries. By teaching people how to give first response care, it dispels fears and misconceptions people have when someone is having a mental health issue or crisis. In the final analysis we all need to think about what we can practically do to enhance our mental wellbeing. With mental health resources stretched, it has to be better for everyone if we are equipped to look after ourselves and support those around us. For more info go to mhfaengland.org Deborah Evans is Managing Director of Pharmacy Complete. Go to pharmacycomplete.org
F E AT U R E
Can nibbling on cheese help prevent cardiovascular disease? Don’t believe the hype: health headlines dissected WORDS BY
Amy Schofield
T H E R E SE A RC H
T H E DE A L
Researchers at Soochow University, The First Hospital of Hebei Medical University, and Yili Industrial Group, in China, carried out the study. This meta-analysis evaluated 15 previous studies from Europe and the US, which recorded the diet and health outcomes of more than 200,000 people and looked to see if there was a link between the consumption of cheese and cardiovascular disease (CVD). Researchers identified the studies that quantified how much cheese people ate, as recorded in dietary questionnaires, focussing on those studies that had collected data on CVD, coronary heart disease and strokes. They then followed up the participants, comparing high and low daily cheese consumption, as reported in the questionnaires, with high consumption considered to be around 40g a day.
On the face of it, the results show that eating cheese every day could protect us from CVD, coronary heart disease and stroke. Some of the reports in the media invited us to ‘indulge’ in a cheese-fest, however, this type of meta-analysis can demonstrate patterns, but can’t show that a single factor has a direct causal effect on another – for example, a reduced chance of stroke. Three of the study authors worked for the Yili Group, a large producer of dairy goods in China, but declared no conflict of interest. It was also reported that the positive findings could possibly be linked to healthier people being more likely to eat cheese.
T H E R E SU LT S T H E ST ORY
CHEESE BOARD
Saturated fat is bad for you, then suddenly it’s good for you. We’re used to seeing conflicting health headlines when it comes to what fat does to our health. Cheese, with its high saturated fat content, is often portrayed as a food baddie when it comes to heart health. Results from a new study, however, claim that eating a small amount of cheese could have nutritional advantages.
CHEESE
can be made from
COW, SHEEP, GOAT, BUFFALO OR YAK MILKS
Q: What’s the best cheese to hide a horse? A: Mascarpone.
The research results, published in the European Journal of Nutrition, showed that people who regularly ate cheese were 14% less likely to develop coronary heart disease. In addition, their chances of having a stroke were reduced by 10%, and the risk of any type of cardiovascular disease was reduced by 10%. The beneficial effects were seen in those people who ate, on average, the high amount, approximately equivalent to a matchbox-sized piece.
30
g
PIECE OF CHEDDAR CONTAINS PROTEIN, VITAMIN B12, PHOSPHORUS, 10.5G OF FAT, 125 CALORIES AND AROUND 30% OF THE RECOMMENDED DAILY CALCIUM INTAKE FOR ADULTS
Source: cheeseboard.co.uk
W H AT T H E PR E S S SA ID: ‘Eating cheese every day may actually be good for you’ TIME ‘A piece of cheese a day keeps the doctor away’ Daily Mail ‘Eating cheese every day may help to protect heart health’ Medical News Today
I heart you
CHEDDAR
is the
UK’s
FAVOURITE CHEESE
M AG A ZI N E | JA N UA RY 2018 | 2 3
Through the
KEY CHANGES
1.
A focus on population health and outcomes, with a whole raft of meaningful outcomes, including heavy issues, such as life expectancy.
2.
A long-term approach with financial incentives. The Multispecialty Community Provider contract runs for 10 years or longer, and the incentives are aligned to improvements in outcomes.
3.
Incorporating integrated services, breaking the barriers between primary and secondary care, health and social care, and developing multi-disciplinary teams for specific patient groups. In many areas, this also includes voluntary sector and other community assets.
4.
Delivering services systematically and at scale to drive efficiencies and reduce variation. 2 4 | PH A R M A FI EL D.CO.U K
Ground CONTROL Are the latest NHS changes just more arbitrary reorganisation or something more compelling?
T
he NHS reorganisation of 2013 was described by Sir David Nicholson, then Chief Executive of the NHS, as being “so big you can see it from the moon”. Andrew Lansley’s goal was to dismantle and reassemble much of the architecture of the NHS; a plan which seemed to get bigger by the month. One bright idea for change triggered a litany of plans to plug gaps and silence dissent, while the simplified system got more complex. Many have their own views on whether those reforms were worth the upheaval, or if we should reserve judgement until some undefined future, when it all either works or fails. The current changes happening in the NHS, however, feel more significant than what happened in 2013. We don’t have a new Act of Parliament or new types of organisation. We do have a whole new approach, which many at the sharp end of commissioning see as the most fundamental and exciting change in healthcare delivery since the conception of the NHS. So, who’s developing these plans and what’s the big idea? Well, despite my enthusiasm, it’s a bit of a challenge to nail down. It, of course, involves the Five Year Forward View, Simon Stevens’ vision and the document that kick-started the new approach. The plan introduced ‘New Care Models’ and ‘Accountable Care Organisations’ (ACOs). The oversight of the local plans involves the STPs – Sustainability and Transformation Partnerships (formerly plans) – which are not new organisations, but rather a collaboration between local health and social care leaders to drive forward ‘place-based’ plans for service reconfiguration. Accountable Care Systems are an alternative to the big ACO procurements currently being undertaken in some areas. They bind organisations through an ‘alliance agreement’ and, importantly, emphasis is placed on organising community care in hubs which support 30-50,000 population. This latter approach is based on the ‘Primary Care Home’ model developed by the NHS Confederation at grass roots level.
OPINION
“ A key challenge for those in the NHS is learning to trust and understand the commercial sector ” WORDS BY
G R E AT E XPEC TATI O N S These developing organisations and alliances carry a weight of expectation relating to the anticipated cultural change. A focus on outcomes, rather than transactions, will mean a greater emphasis on aspirations rather than specifications, uniting stakeholders in quality improvement activities. The contracts being developed also place providers under pressure to exert systems leadership and affect change outside their direct control, for example, influence over education, housing, transport and leisure. Now we come to the inevitable and recurring question - what it means for pharma. Arguably, the biggest opportunity relates to being part of a system which incentivises performance in improving patient outcomes. This does prompt two
further, somewhat familiar questions, which companies may be wrestling with. Can both pharma and healthcare providers enter into meaningful yet pragmatic, outcome-based commercial relationships or will it be business as usual? And, if relationships rooted in outcomes can work, is there enough financial headroom to allow the incentives to reach a pharma partner? The first question relates to each party’s willingness to take risks, work through potentially tricky compliance and procurement barriers, and perhaps most importantly, the ability of both to simply make it work on the ground. I have rarely met anyone from pharma who is content for their role to be simply selling medicines. Most want to develop and work in partnerships with the NHS, but a number of challenges come with this.
MORPh NHS learning sets are back! Book your place now : 01905 612789 rachel@morphconsultancy.co.uk
Morph Consultancy @MorphCLtd @MorphConsultancy
23rd January 2018, London New Care Models, Tools to segment and track development of NCM and What is the impact on services and Pharma? Dr Duncan Jenkins, Specialist in Pharmaceutical Public Health Dudley CCG
Dr Duncan Jenkins
Can you shift from a single product focus to a pathway, programme of care, or population, even if it means working with other companies? A second challenge comes from the need to influence things outside your control or remit, for example supporting a prevention agenda. A key challenge for those in the NHS is learning to trust and understand the commercial sector and give both parties the freedom to make it work. If we can get to this Nirvana – and in my opinion, this is the best chance we have ever had – then will the economics work, not just on paper, but in the real world with real patients? I’ll be taking on these opportunities and challenges in the next two issues. Dr Duncan Jenkins is a Director at MORPh, specialist training providers for CCG, clinical, practice and GP pharmacists. Go to morphconsultancy.co.uk
20th February 2018, London An update on RMOCs and the Wider Medicines Agenda Julie Wood, Chief Executive, NHS Clinical Commissioners 20th March 2018, London NHS Rightcare Carl Marsh, NHS Rightcare Delivery Partner 18th April 2018, Leeds Sustainability and Transformation Partnerships Helen Liddell, Head of Medicines Optimisation Leeds CCGs
www.morphconsultancy.co.uk 01905 612789 / 07976 417312
M AG A ZI N E | JA N UA RY 2018 | 2 5
WORTH the WEIGHT? Almost two in every three people in the UK are overweight or obese, but what’s being done to halt the obesity epidemic sweeping the nation? ecently there has been a slew of alarming obesity headlines: Obesity and diabetes 'causes up to 800,000 cancers worldwide every year’; Organisation For Economic Cooperation and Development data shows the UK has the highest obesity rate in Europe; Autism risk increases 36% for children born to obese pregnant women; Obesity epidemic fears as one in three teens are overweight or obese. Meanwhile, the Centre for Social Justice produced a major new report: ‘Off the scales – Tackling England’s childhood obesity crisis’, which laid out in stark detail the ‘obesity time bomb’ which faces the nation. Obesity is a common problem in the UK, estimated to affect around one in every four adults and one in every five children aged 10 to 11*.
WHAT IS OBESITY?
The most commonly used method to calculate whether a person is a healthy weight for their height is body mass index (BMI). For most adults, a BMI of 30 to 39.9 means you’re obese, while 40 or above means you’re severely obese. Waist circumference can additionally be used to measure excess fat in overweight or moderately obese people, and can also show which people are more likely to develop obesity-related health problems. The problem is growing; obesity prevalence increased from 15% in 1993, to 27% in 2015. The prevalence of morbid obesity has more than tripled since 1993, and reached 2% of men and 4% of women in 2015. Almost two in every three people in the UK are overweight or obese (59% of women and 68% of men).**
2 6 | PH A R M A FI EL D.CO.U K
*nhs.uk **Statistics on Obesity, Physical Activity and Diet – England
F E AT U R E
PREVENTION IS BETTER THAN CURE The Obesity Health Alliance (OHA) is a coalition of over 40 organisations which have joined together to fight obesity. The OHA’s goal is to prevent obesity-related ill health by addressing the influences that lead to excess bodyweight throughout life. It recommends that urgent action in 10 areas is needed to tackle obesity, starting in childhood:
1.
PROTECT CHILDREN FROM ALL JUNK FOOD MARKETING EVERYWHERE
2.
BRING IN THE LEVY ON SUGARY DRINKS
3.
REDUCED SUGAR, SATURATED FAT, AND SALT IN OUR FOOD
4.
FEWER PROMOTIONS AND DISPLAYS OF UNHEALTHY FOOD
5.
TRAFFIC LIGHT LABELLING ON ALL PROCESSED FOODS
6.
ALL SCHOOLS TO SERVE HEALTHY MEALS AND TEACH CHILDREN HOW TO COOK
TAC K LI N G O B E S IT Y E AR LY Caroline Cerny, Obesity Health Alliance Lead
O
besity is one of the biggest public health threats facing the UK – with 1 in 5 children entering primary school overweight or obese, rising to 1 in 3 when they leave. This is not only storing up major health problems for later in life, it has a huge economic cost to the NHS. It’s estimated that over £5 billion a year is spent by the NHS on treating obesity-related conditions. The solution isn’t straightforward and there’s no quick fix. There needs to be political will to tackle obesity and we’ve seen this through the introduction of the Soft Drinks Industry Levy and the sugar reformulation programme. But there also needs to be more done to tackle the obesogenic environment which often makes it harder to make healthy choices. We want to see restrictions on junk food advertising prior to the 9pm watershed, as we know thousands of children are exposed to junk food ads and it influences their choices. It’s also important that healthcare professionals are equipped to talk with their patients about weight and that there are local services available for referrals. Tackling obesity requires commitment from Government, industry, the healthcare profession and individuals.
“ The solution isn’t straightforward and there’s no quick fix”
7.
LOCAL AUTHORITIES TO HAVE FREEDOM TO TAKE ACTION ON OBESITY IN THEIR AREA
8.
HEALTHY FOOD AVAILABLE IN HOSPITALS
9.
FULL TRAINING FOR HEALTH AND SOCIAL CARE PROFESSIONALS TO TACKLE OBESITY
10.
Prescription treatments: Orlistat is a capsule that prevents the absorption of fat in the intestine. Marketed as a prescription drug, under the trade name Xenical by Roche in most countries, and sold over-the-counter as Alli by GSK in the UK and US, orlistat is the main prescription product for treating obesity by GPs in England. Surgical options: Bariatric surgery, a group of procedures performed to aid weight loss, includes stomach stapling, gastric bypasses, sleeve gastrectomy and gastric band maintenance. This type of surgery is generally used in the treatment of obesity for people with a BMI above 40, or for those with a BMI between 35 and 40 who have health problems such as type 2 diabetes or heart disease.
FUNDING FOR CHILD MEASUREMENT WEIGHT MANAGEMENT PROGRAMMES. obesityhealthalliance.org.uk
M AG A ZI N E | JA N UA RY 2018 | 2 7
F E AT U R E
Complications The link between obesity and the increased risk of many serious diseases and death is well documented. Potentially life-threatening health conditions associated with obesity include: TYPE 2 DIABETES
• CORONARY HEART DISEASE
• SOME TYPES OF CANCER, SUCH AS BREAST CANCER, BOWEL CANCER & WOMB CANCER
• STROKE
• SLEEP APNOEA
• HIGH CHOLESTEROL
• HIGH BLOOD PRESSURE
• LIVER DISEASE
• KIDNEY DISEASE
• METABOLIC SYNDROME - A COMBINATION OF DIABETES, HIGH BLOOD PRESSURE AND OBESITY
• MENTAL HEALTH PROBLEMS INCLUDING DEPRESSION AND LOW SELF-ESTEEM.
CHILDHOOD O B E S IT Y Over 1 in 3 Year 6 children were measured as obese or overweight in 2015/16. 20% of Year 6 children were obese in 2015/16, compared to 17% in 2006/07.** **Statistics on Obesity, Physical Activity and Diet – England
2 8 | PH A R M A FI EL D.CO.U K
“ I realised I was controlling my health, my health wasn’t controlling me” PE RSO NAL S TO RY
A
lyson Syms, 36, reversed her type 2 diabetes by following a weight loss plan that saw her lose a total of 12st 5lbs, taking her from 23st 1lbs to 10st 10lbs. “I wasn’t obese all my life. I was a premature baby and my mum had had my stillborn brother the year before. Scared that she would lose me too, she listened to the doctors when she was told to feed me every hour, to make sure I grew. I was still tiny as a toddler, but as I went through school, my weight crept up. By my teenage years I was obese. Those years were hell. I never attended a school disco and dreaded non-uniform day. What do you wear when you’re 14 and an adult size 18? In high school I was bullied horrendously. I was called names, pushed down the bus staircase and once I was thrown down on the school field and had grass shoved in my mouth. I learnt quickly to bottle up my feelings, pretending I didn’t care. When I got home I sat and ate. Taking enjoyment out of food was the only pleasure in my life. I met my partner, Jim, in 2011, and the following year we bought a house and got engaged. We both work long hours and have custody of his son, so we slipped into a bad routine of consuming fast food. I developed type 2 diabetes in 2012, which the doctor told me was due to my size and lifestyle. I was put on meds, including injecting insulin three times a day and taking NovaRapid and Metformin, but still my blood sugars were out of control. I was referred to the diabetic clinic in the women’s unit at my local hospital. I longed for a baby, so it was
so upsetting seeing other women there for scans, while I was being told I was putting my life at risk. I had an early miscarriage in 2012. The one thing I’d always wanted had been snatched away from me. The nurse told me that it was very unlikely my body would be able to carry a child. Then something clicked. I was determined that everyone was going to look at me for the right reasons when I walked down the aisle on my wedding day. There’s no way I was going shopping for a size 32 dress; I was going to be a perfect 12! One of my friends told me about Cambridge Weight Plan. Consultant Sarah Smith came to see me on a Sunday evening on her day off. At 23 stone 1lbs, with type 2 diabetes, I started my journey. Sarah’s words were: “Give me 12 months and we can change your life.” And we did. The weeks flew by. People noticed changes and the compliments spurred me on. Every visit to the diabetic nurse saw a reduction in my medication, which is when I realised I was controlling my health, and my health wasn’t controlling me. 12 months later I had completely reversed my type 2 diabetes and was discharged from the clinic. I cried with pride that night. I had to come off the plan for a little while due to having an operation, so it took me until August 2017, but I hit my goal of 11 stone. I was half the woman I used to be! I do hope one day I become a mum, but if it doesn’t happen, I’ll know I did everything in my power to make that dream become a reality.” cambridgeweightplan.com
I
P H A R M ATA L E N T
n a new series we look at how winning a Pf Award transforms every aspect of a winner’s life, not just the professional side…
PERSO NAL I’ve been in this amazing industry for over 20 years and this was the first time I had ever entered the Pf Awards. I saw it as a real opportunity to challenge myself and so, with a combination of self-doubt and excitement, I entered the room of the assessment centre, and faced whatever challenges lay ahead. During the process, I was given an opportunity to be benchmarked, but also to share my passion about the impact industry can have on patients’ lives, and the HCPs that directly serve those patients. I conveyed this by being true to my beliefs and, pivotally, being myself. I relied on the experience I had gained in the last two decades, and found the confidence to be myself. Therein lies the biggest impact that winning an award has had on me – confidence. As a result, I continue to raise the bar with all interactions I have and this has opened many doors.
NAME: ALISON DUNCAN AWA R D : S E C O N DA RY C A R E S P E C I A L I S T 2 0 17
PRO FES SI O NAL From a professional point of view, AbbVie places a huge focus on continued personal development, actively seeking to continue developing their employees and providing a culture of openness and transparency. At this company, I already felt I had a voice, however, this year I have been given access to business coaches, courses and one-on-one time with the leadership team, where I feel my capabilities are fully recognised. I now have a much clearer vision about my next career step and feel highly supported in reaching those goals over the next couple of years.
RECR E ATI O NAL The increased confidence has also impacted my overall daily life. Striking the balance between the demands of a busy job and those of a hectic family are not always an easy task! I was managing the two reasonably successfully, but the focus on my own health had become bottom of my to-do list. Winning the Pf Award prompted me to reassess all areas of my life. In my youth I had been a competitive swimmer and a grade 8 pianist, and I had forgotten how much I loved those hobbies so, in the last nine months, I have dived back in the pool and am on track to reach my health goals in a couple of months. I am also back as chairman for a youth community choir where I get to share my love of music with children and watch their own confidence improve every week.
O U T S TA N D I N G P E R FO R M E R 2 0 17
THIS IS YOUR LIFE PF AWAR D WI N N E RS:
WORDS BY
John Pinching
R E A D Y F O R A L I F E - C H A N G I N G W I N ? V I S I T P F AWA R D S . C O . U K T O F I N D O U T M O R E
M AG A ZI N E | JA N UA RY 2018 | 2 9
OPINION
TWO TAKES SHOULD THE NHS BE PRIVATISED? An all-new opinion battle where one divisive subject erupts, giving way to diametrically opposing views from two senior healthcare commentators.
YES
NO
JA N E D E V I L L E ALMOND Independent Nurse Consultant and journalist
H
aving worked in the NHS for almost two thirds of its existence, I love it and its values. Anyone who dedicates a life to the NHS is committed to Bevan’s principles – healthcare provision based on clinical need, not on ability to pay. But healthcare is not free. Healthcare costs the NHS £116 billion per year and the money comes from us. The NHS was developed at a time when children were still dying of polio, before kidney transplants, heart bypasses, breast screening and fertility treatment. Who could have foreseen the change in UK demographics and the impact this would have? For fear of losing popularity, no one in Government seems prepared to admit that the NHS is simply too expensive to run without making difficult changes. Already we are seeing community services for the elderly stretched, mental health services almost nonexistent in many areas, GPs so overwhelmed they are leaving and nurses so overworked that hospitals are unable to recruit them. The big fear is, if we refuse to look at other models, the NHS could fold completely. The NHS loses millions every year. Partly because many have no respect for it, partly because people have little idea of the real costs, and partly because no one is in control. For those who can afford it, we should charge a fee for visiting a GP. Where people can’t, then we subsidise, as they do in Jersey. Charge people for missed appointments, make sure people know the cost of medicine waste and encourage people to look after their own health. We need to stop living in the past and move forward with innovations brought by involvement with the private sector.
3 0 | PH A R M A FI EL D.CO.U K
D R G U Y P I L K I N G TO N Assistant Chair of NHS Newcastle Gateshead Clinical Commissioning Group
T
he challenges facing healthcare systems across the world are as great now as they have ever been. Why should we stick to the founding principles of the NHS, when the pressures upon it grows inexorably? Let me explain. The NHS is designed to be comprehensive and accessible to all regardless of ability to pay. The welfare state was created as a universal service and remains one of the few foundations on which our sense of shared community is built. Margaret Thatcher was wrong, there is such a thing as society and the NHS remains the clearest articulation of that. Remind yourself of these values and read the NHS Constitution when you get the chance. The most costeffective way to fund a universal system is through general taxation. We have an ageing population, pressures grow year on year, so let us commit to the best way of doing that. The NHS is far from perfect. I believe it has yet to invest in prevention, mental health and caring for the most marginalised at the levels required to tackle stark inequalities we see across the nation. Part of that requires us to stop over-medicalising many of the things we deal with on a daily basis – unhappiness, loneliness, the effects of poverty and traumatic events in childhood. A privatised system is incapable of rising to these challenges, and will worsen the inequalities of access and outcome we have today, costing the nation far more. Remember, the UK was judged as the top rated health service in the Commonwealth Fund think tank 2017 comparison, despite nearly 10 years of funding squeezes and a much lower proportion of GDP spend on healthcare than more privatised systems.
S
Truth hurts: Britain has a weight problem that can only be solved with honest interaction and digital functionality.
peak your weight machines – where have they gone? Or did they only ever exist in Saturday morning cartoons? According to stats, most of us wouldn’t want our weight spoken out loud at any time, let alone in a shopping mall or high street. The fact is, and I know because I see the stats from our BMI calculator, which churns out 800k results per month. Once we’ve had our 21st birthday, it’s pretty much downhill in terms of weight management. Overweight is the new norm. And this extends to our children, where normalisation has meant parents accepting overweight as normal; not unhealthy. This has, in turn, bred an excuse culture in which parents conclude that, ‘all the other kids are the same’. It seems particularly salient to mention this now, in the aftermath of Christmas, when we all routinely procrastinate, eating and drinking ourselves to a standstill or oblivion, whichever comes first. In response to the current situation, NHS Choices is currently exploring how we can improve our BMI calculator to better meet user needs. Despite Public Health England and NHS Choices having any number of subject matter experts and policy leads on diet and obesity, we are not the end user, and the age of experts dictating what people need to do is mostly confined to the archives, at least within NHS Digital. We may think we know best – and experience is still critical in delivering quality tools –
Martin Moth
WORDS BY
OPINION
“ We’re not the end user, and the age of experts dictating what people need to do is mostly confined to the archives” but when we see ‘real’ people using our tools, we’re constantly surprised by how difficult or confusing small things can be to people who are occasional or one-off users. We have to concede that, even in the digital universe, the human element is still the most important. With just two days of testing, we recently increased the rate at which users click through to further information on our Heart Age tool from 3% to 13%. That is a massive improvement, and means an extra 100 people per day now get better information on helping them reduce cardiovascular risk. If you are looking to create a digital health tool to support medication adherence, or even something as seemingly simple as an internal travel booking form, first do some user research to define what they really want. Google ‘GDS Design Principles’ is a good place to start. It’s short and sweet, and won’t send you to sleep. Trust me, I’m a user. In the meantime, I’ll use the same rigorous user testing process to help people with the BMI results they receive. This is the digital age and just ‘speaking your weight’ isn’t going to cut it anymore. Martin Moth is our new digital columnist and Digital Tools Lead at NHS Choices. Go to nhs.uk/bmi
Weight category
AGE GROUP
By proportionate share for the period 6/11/2017 – 6/12/2017
4-5 6-11 12-14 15-17 18-20 21-30 31-40 41-50 51-60 61-70 71-80 80+
Underweight Healthy weight Overweight Obese
20
40
60
80
100
PROPORTIONATE SHARE
M AG A ZI N E | JA N UA RY 2018 | 3 1
Have you got what it takes? Time to prove it!
Only the best in the industry will share the stage with Hal Cruttenden at the Pf Awards Dinner this March. Enter today and find that winning feeling in 2018.
D O N ’ T M I S S TH E I M P O RTA NT DATE S FO R YO U R D IA RY:
Deadline for entries T H U R S DAY 01 M A R C H 2 018 : Assessment Day, King Power Stadium, Leicester T H U R S DAY 0 8 M A R C H 2 018 : Pf Awards Dinner, Royal Lancaster London M O N DAY 2 2 JA N UA RY 2 018 :
For more information visit P FAWA R D S .CO. U K or contact the events team on 01462 476120 # P FAWA R D S 2 018
GOLD SPONSORS
S I LV E R S P O N S O R S
SPONSORS
P H A R M ATA L E N T
MOVERS & SHAKERS
PHARMA
AN D R E A S B USC H Shire has appointed Andreas Busch as Executive Vice President, Head of Research and Development, and Chief Scientific Officer. He will be joining from Bayer AG, where he was Head of Drug Discovery. “Andy is an outstanding scientist with an established track record of building broad portfolios that encompass both biologics and small molecules,” said Shire’s Flemming Ornskov.
PHARMA
PH I LI P J O H N SO N
WHO’S GOING WHERE AND WHY THEY’RE GOING THERE. WORDS BY
Lilly has appointed Philip Johnson as Senior Vice President and Treasurer. He was previously Vice President, Investor Relations at Lilly. Philip has been with the company for 22 years, serving in a variety of financial roles in the US and overseas.
Rachel Cresswell
3 4 | PH A R M A FI EL D.CO.U K
KNOW A RISING STAR WHO DESERVES A MENTION? RACHEL@PHARMAFIELD.CO.UK
PHARMA .
B E N C L AR K Ben Clark, winner of the New Account Manager Pf Award 2017, has been appointed by Ferring Pharmaceuticals as Key Account Manager. He was previously Urology Account Manager at Astellas Pharma Europe.
MULTI-CHANNEL INSIGHTS PERFORMANCE
AG E N CY
RUTH ROS TRO N Inceptua Medicines Access has appointed Ruth Rostron as Senior Project Manager. Her experience stems from working in multinational companies for the past 15 years and, most recently, she worked as Oncology Brand Manager for Astellas Pharma.
NHS
IAN DALTO N Ian Dalton has been announced as the new Chief Executive of NHS Improvement, replacing Jim Mackey who held the post for two years. He has an extensive track record in NHS management, having served as Chief Operating Officer and Deputy Chief Executive at NHS England.
Inicio provides a range of multi-channel effectiveness, insights and performance services to help pharmaceutical and life sciences organisations to evaluate the impact of their multi-channel and brand strategies.
QUALITY INTEGRITY COLLABORATION COMMITMENT
+44(0)7595 821220 info@inicio.consulting www.inicio.consulting
M AG A ZI N E | JA N UA RY 2018 | 3 5
Set yourself up for a successful 2018 by joining the leaders in pharma recruitment.
PharmaJobs offers bespoke recruitment solutions, whether you need up to 50 roles on a short-term basis, or an annual contract to cover all your recruitment needs. Make sure you’re attracting the right talent – sign up for a free trial today or contact rachel@pharmafield.co.uk to discuss your online recruitment strategy.
PHARMAJOBS.CO.UK
W H E R E TA L E N T G R O W S
P H A R M ATA L E N T
P H A R M ATA L E N T S E R I E S
WOM EN of PH A R M A
I
n a special series of exclusive PharmaTalent interviews we shine a light on the women leading, inspiring and blazing a trail within industry. Pf ’s Political Correspondent, Claudia Rubin, wrote recently about how pharma has a long way to go in offering equal career opportunities to women, citing the fact that among the top 20 pharmaceutical companies, as ranked by sales in 2016, senior female executives represented just 17% of the management team. ‘Pharma knows it must find a way to encourage more women to rise through its ranks’, Claudia wrote. According to the Pf People 2017 Perception, Motivation and Satisfaction Survey Report, the pharma industry is represented by more females than males, at 58% to 42%. Women in pharma also appear to have greater longevity, with the survey finding that more than 15% of female respondents have been working in the pharmaceutical industry between 11 and 20 years. Women’s roles are evolving, and pharma is one industry where they can rise through the ranks, as the success stories of the inspirational women featured in our new series show.
M AG A ZI N E | JA N UA RY 2018 | 3 7
P H A R M ATA L E N T
WOMEN OF PHARMA
Martina Muttke
Head of International Medical Affairs at Shire, on what it takes to be a successful woman in pharma.
INTERVIEW BY
Amy Schofield
3 8 | PH A R M A FI EL D.CO.U K
How did you get where you are today? I trained as a doctor but, after my studies, I didn’t want to commit to a certain specialty, or be bound to a particular place. My grandmother owned a pharmacy, and I always found drug development fascinating. I started to become interested in pharmaceutical industry opportunities, and saw possibilities for roles in areas like marketing, research and medical. I started my career as a Medical Adviser in Virology at a pharmaceutical company and then worked in multiple therapeutic areas, before moving on to more managerial roles. Today, looking at what my team and I are doing at Shire, I am especially happy to see how we focus on putting the patient at the centre of our efforts. For me, this is what our work is ultimately about. What do you do? I’m head of the International Medical Affairs team at Shire, the leading global biotech company in rare diseases. We are the champion for people with rare diseases – one of the most overlooked patient populations in the world. I lead the medical teams in over 70 countries outside the US and spend a lot of my time finding, empowering and retaining talented people who are able to create a positive, patient-centric culture throughout the world. Medical Affairs has become a critical area in both the pharma and biotech industry. The challenge is to excel in science, entrepreneurialism, communication and courageous leadership – all at the same time!
What contributes to your success? Curiosity, courage, a passion for people, foreign cultures and the desire to be a lifelong learner have all helped me through my working life. When I started my career in pharma, a very senior executive urged me to plan my career step-by-step in advance, with clear milestones and timelines. I disregarded that advice and, instead, looked for opportunities that were fun, and followed my heart. My flexibility and high level of ambition have helped my career, as have a positive mindset and determination never to take “no” for an answer!
Do women have to work harder in pharma? I feel women need to work as hard as men – this is not a gender issue. I have always been offered the same chances as my male colleagues. I know a lot of male managers who prefer to hire and promote women, because they have been convinced by their qualities and performance. When I asked some female colleagues this question, their responses were mixed. Some felt a definitive “yes”, because they think there is still not enough female representation at the top. Without doubt some women do encounter gender barriers, but this is not only in pharmaceutical companies, and I do see this changing. How can the pharma industry attract and retain more senior female executives? Attract us by offering more flexible working conditions, great pay and outstanding development opportunities. Provide support to women that allows a balance between work and family. This is also about company culture – when it comes to retention, companies should not only focus on creating diversity discussions and coaching programmes, but actively promoting women into senior roles in the organisation. What qualities and talents does a woman entering the pharma industry need? I asked this question to some of our female leaders at Shire, and received interesting answers. First of all, you have to be good at your job. Competence is a basic quality; as is persistence, empathy and high self-esteem. Another important element is common sense, a mindset which is often underestimated. Studies show female brains to be better wired for leadership; less impulsive behaviour, better judgement and more empathy. Women can be strong leaders
by displaying these qualities, and thus become huge assets for the company. What’s the best piece of careers advice you’ve ever been given? Luck is preparedness meeting opportunities. What does your professional future look like? What I find really interesting is the new role of ‘Chief Patient Officer’. It’s great to see the realisation that the patient is indeed our most important customer. Patients are becoming much more responsible in managing their health, which is largely attributable to our world going digital. Patients will soon request participation in all stages of a drug’s development and lifecycle, as an active partner. This will be a fascinating advancement in the coming years, and a real challenge for industry. Shire is on this journey as a very patientcentric company, and I’m excited to work further on how we can best serve individual patient needs.
“ Companies should not only focus on creating diversity discussions and coaching programmes, but actively promoting women into senior roles”
T:7.2677”
T:1.5748”
And so we support In the fight against rare disease, the more we collaborate, the bigger the possibilities. Champion the fight against rare disease with us at shirepharmaceuticals.co.uk C-ANPROM/UK//0668 Date of Prep: Nov 2017
M AG A ZI N E | JA N UA RY 2018 | 3 9 ShiCo4511_Banner_Ad_For_UK_Option2-4_FINAL.indd
O N YOU R R A DA R
AOB
MEDS UP Approvals and rejections from the FDA and EMA/CHMP
A P P R OVA L S
FA NA P T U M
A P P R OV E D D R U G O F T H E M O N T H :
ZEJULA TESARO. FO R : Recurrent ovarian cancer. Approved by EMA as a monotherapy for the treatment of adult patients with platinum-sensitive relapsed high grade serous epithelial ovarian, fallopian tube or primary peritoneal cancer who are in response to platinum-based chemotherapy. C O M PA N Y:
R E J E C TI O N S
Vanda Pharmaceuticals. Schizophrenia. The marketing authorisation application of the drug, for the treatment of schizophrenia in adult patients in the EU, was rejected by the CHMP after a re-examination of the negative opinion originally adopted in July 2017.
C O M PA N Y: FO R :
THE THREAT IS REAL As the spectre of antimicrobial resistance (AMR) looms large and the supply of effective antibiotics dwindles, Lord Jim O’Neill, author of a landmark report on AMR, said that the UK Government has ‘lost focus’ on the challenge over the past 18 months. Speaking at the launch of the AMR Centre in Alderley Park, Cheshire, he also urged industry to take action, saying: “I have seen evidence of encouraging early research and we need big pharma to take a more openminded approach and back these ideas with their own money.” IN A HEARTBEAT A team led by Johns Hopkins researchers has constructed a powerful new computer model that replicates the biological activity within the heart that precedes sudden cardiac death. With this knowledge, researchers will be better able to develop treatments to keep some deadly heart rhythms from forming.
ON Z E A L D J U LUC A ViiV Healthcare. FO R : HIV-1. The FDA approved Juluca is the first complete treatment regimen containing only two drugs to treat certain adults with human immunodeficiency virus type 1. This is instead of three or more drugs included in standard treatments. C O M PA N Y:
Nektar Therapeutics UK. FO R : Advanced breast cancer which has spread to the brain. Nektar requested re-examinations of the Committee’s negative opinion adopted in July 2017. The CHMP re-examined the initial opinion and confirmed its recommendation to refuse marketing authorisation. C O M PA N Y:
A BI L I F Y M YC I T E Otsuka & Proteus Health. Schizophrenia, bipolar disorder and depression. The first ever ‘digital’ pill with a built-in sensor to track compliance has received FDA approval, 19 months after originally being rejected over safety concerns. The pill combines Otsuka’s aripiprazole with an ingestible sensor produced by Proteus Health.
C O M PA N Y: FO R :
4 0 | PH A R M A FI EL D.CO.U K
ATA LU R E N PTC Therapeutics. FO R : Duchenne muscular dystrophy. The FDA declined to approve the experimental drug to treat a genetic condition, which affects young boys, saying that an additional clinical trial would be needed to prove the drug works. C O M PA N Y:
VIRTUAL GAIN Sharing weight loss journeys via social media plays a vital role in achieving success, according to a study from the University of California, Irvine, which examined the role of virtual communities and public commitment in setting weight loss targets. The research found that ‘individuals are more likely to realise success with personal goals when they make a public commitment to attaining them’.
SOMETHING THAT SHOULD BE ON OUR R ADAR? R ACHEL@PHARMAFIELD.CO.UK
The results are in The Pf People Survey Report is the essential benchmarking tool for the UK pharmaceutical industry, providing analysis and insight into all the key results from the Pf Perception, Motivation and Satisfaction Survey. How does your company compare? The survey was taken by over 450 respondents from over 44 companies.
P R I M A RY R O L E S
P R I M A RY F U N C T I O N
54% 68%
AV E R AG E S A L A RY
ÂŁ42k
of respondents class themselves as primarily customer facing
primarily work in Sales/Business Development
The average UK salary in pharma is ÂŁ42k
M A I N T H E R A PY A R E A
CAREER PROGRESSION
M O S T D E S I R E D C O M PA N Y
Cardiovascular
Respiratory
Diabetes
68% of respondents represent the three big chronic disease areas
1 in 5
?
respondents are looking to change companies in the next 12 months
What does the Pf Survey mean for your company? Are your employees satisfied with their bonuses? Which benefits do your employees value the most? Who is the most desired pharma company to work for?
How desirable is your company to work for?
CO M PAR E YOU R I NTE R NAL S U R V E Y R E S U LT S
If you have carried out an internal survey this year, maximise your asset by comparing the results with our industry-wide survey. Email hello@pfpeople.co.uk, call 01462 476119 or visit pfpeople.co.uk for more information.