Pf Magazine June 2019

In pharma we trust?

Pharma and the medical profession have a crucial partnership; why is opinion polarised on the issue of trust? Page 10 JUNE 2019

Prevention over cure Primary Care Networks LinkedIn & the ABPI Code PHARMAFIELD.CO.UK

POWER LIST

WHO IS SHAPING THE PHARMA & HEALTHCARE SECTOR? NOMINATE TODAY FOR THE PF POWER LIST 2019 CATEGORIES Politics

Inspirational leadership

Women leading the way

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Mentors making a difference

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Best practice

Changemakers

Corporate social responsibility

You call it – for nominees who don’t fit a category

EMAIL DETAILS OF YOUR NOMINEE: person, team or organisation, with a paragraph on why you think they should be on the Pf Power List 2019 to emma.morriss@pharmafield.co.uk

T

Hello.

his month, I am delighted to bring you the results of our survey into whether healthcare professionals (HCPs) trust the pharmaceutical industry. You will see that it has yielded some interesting results. It’s clear that there is a certain level of distrust in industry by HCPs and there’s work to be done to address that.

We’re hoping this will become an annual survey to benchmark the current levels of trust published here and identify whether this will improve in the future.

We also have an inside view on the NHS, commissioning and ABPI with articles exploring primary care networks, the changing face of commissioning and guidance on the use of LinkedIn and the ABPI Code of Practice. If you have any specific insights you’d like on these elements of industry, please let me know as we have regular articles scheduled all year.

Our therapy area this month explores diabetes. Although Types 1 and 2 are most commonly discussed, there are rarer types including Type 1.5 diabetes or latent autoimmune diabetes in adults. Take a look at the article to find out more.

Did you know that the political tide is turning towards prevention? A recent survey

by WA Health set out to discover the extent to which MPs backed the Long Term Plan, and in particular whether they would be in favour of a shift to prevention over treatment. We have the results of the survey and insight into what they mean for the pharmaceutical industry.

Finally, I’m delighted to bring you the first of our Pf Awards 2019 Winners Interviews. Shannon Travers won the Best Newcomer Award at the Pf Awards Dinner in March; she shares her thoughts on her career so far and why listening to her mum was one of the best decisions she made.

Thank you for taking the time to read this issue of Pf Magazine. Next month, we have a special interest on patient centricity, so be sure to look out for that.

In the meantime, don’t forget to visit our website www.pharmafield.co.uk regularly for news updates and exclusive content. And if you’re looking for a new role in the industry, our new-look PharmaJobs website www.pharmajobs.co.uk, is where pharma talent goes.

HEAD OF CONTENT

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

Amy Schofield amy@pharmafield.co.uk CREATIVE DIRECTOR

Emma Warfield emma@pharmafield.co.uk GRAPHIC DESIGNER

Olivia Cummins olivia@pharmafield.co.uk COMMERCIAL DIRECTOR

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

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

Hannah Alderton newsdesk@pharmafield.co.uk FINANCIAL CONTROLLER

Fiona Beard finance@e4h.co.uk Pf AWARDS

Melanie Hamer melanie@e4h.co.uk PUBLISHER

Karl Hamer karl@e4h.co.uk HEAD OFFICE

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

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.

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M AG A ZI N E | J U N E 2019 | 1

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

GET IN TOUCH: hello@pharmafield.co.uk

Contributors

@pharmafield

DR ZUBAIR AHMED

Dr Zubair Ahmed is a General Practitioner and the Chief Executive Officer of Medicspot, an innovative digital health company working closely with community pharmacies to make high-quality healthcare more accessible.

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

@pharmajobsuk

Pf Magazine

CAROLINE GORDON

SARA BAINBRIDGE 

Sara Bainbridge is Head of Policy and Delivery at NHS Clinical Commissioners, the independent membership organisation for clinical commissioners. Sara is on secondment from her role leading the health policy team at Cancer Research UK. MAGNUS FRANZEN

Magnus Franzen works at PEN CX and is an expert consultant in Customer Experience in Life Sciences. He helps clients become more relevant in their customers’ and patients’ lives.

Caroline Gordon is Director of WA Health. She has worked across the pharmaceutical and voluntary sectors and is a former advisor to a government minister.

WA Health is an insights-led healthcare government affairs consultancy which specialises in making complex issues clear.

STEVE HOW

Steve How is Programme Director for Wilmington Healthcare’s Consulting Team and has more than 20 years’ experience working in the healthcare and pharmaceutical industries.

He is passionate about partnership and public engagement with the NHS and sits on the board of one of the new Integrated Care Partnerships as Chair of the Citizens’ Council.

OLI HUDSON 

Oli Hudson is Content Director for Wilmington Healthcare. He oversees material for training and education, consultancy services, network meetings, thought-leadership, events and webinars. In previous roles at the company, he has worked with the NHS and industry on a wide range of training, access, collaboration and partnership projects.

In this issue

LOUISE LAVELLE 

Louise Lavelle is Team Lead of the Healthcare Communications division at Carrot Pharma Recruitment.

With over 13 years’ experience within the recruitment industry, she offers specialist knowledge within the world of medical education and medical communication.

RINA NEWTON 

Dr Rina Newton is Managing Director of CompliMed, experts on the ABPI Code.

CompliMed supports any activity that results in better engagement with the ABPI Code, transparency and consistency in PMCPA case rulings and improvements in self-regulation.

IAN ROBINSON 

Ian Robinson has 20 years’ experience in sales management and senior leadership roles within UK pharmaceuticals. His passion is commercial excellence, with a particular focus on the role of the first line manager.

04 NEWS

THERAPY AREA

28

Bringing you this month’s essential headlines

Type 1 and Type 2 diabetes and beyond

COVER STORY

10

MARKETING

Do healthcare professionals trust pharma?

Communicating with your customers

POLITICS

14

PHARMACY

Interpreting the new political language of the NHS

Why we need community pharmacy more than ever

INSIDE THE NHS

16

PF AWARDS

Transforming primary care through primary care networks

Pf Awards 2019’s Best Newcomer, Shannon Travers

FEATURE

18

38

The importance of coaching the coach

Realising FMD’s future potential

INSIDE COMMISSIONING

22

40

The changing face of NHS commissioning

Growing graduate pharma talent

COFFEE BREAK

24

MOVERS & SHAKERS

Transition and transformation in pharma

Who’s moving where in the industry?

26 ABPI

44

LinkedIn and the ABPI Code of Practice

How to get into a healthcare agency

32

34

36 Q&A

PF TALENT

42 CAREERS

QUICK DOSES N I C E has recommended Lenalidomide in combination with dexamethasone for patients with multiple myeloma as a first- and second-line drug.

• M S D ’s KEYTRUDA (pembrolizumab) has been recommended for approval of a new extended dosing schedule

by European Medicines Agency.

• The U S FO O D A N D D R U G A D M I N I S TR ATI O N (FDA) has also approved an expanded label for KEYTRUDA for the first-line treatment of patients with stage III non-small cell lung cancer.

• N I C E recommends funding for B I O G E N U K’s Spinraza (nusinersen) for spinal muscular atrophy.

• N OVA RTI S’ Aimovig® (erenumab) has been accepted for restricted use in NHS Scotland by Scottish Medicines Consortium for prevention of chronic migraine in adults for whom at least three prior preventive treatments have failed.

• N OVA RTI S has also presented new data demonstrating sustained efficacy of Aimovig to 52 weeks.

• N I C E recommends B R I S TO L M Y E R S S Q U I B B’s Opdivo® (nivolumab) plus Yervoy ® (ipilimumab) for use within Cancer Drugs Fund.

• N OVA RTI S has received FDA filing acceptance and Priority Review of brolucizumab (RTH258) for patients with wet AMD. • N I C E has published final recommendation for ILUMETRI® (tildrakizumab), as a cost-effective option for adults with moderate-tosevere plaque psoriasis.

• N I C E recommends M S D ’s Steglatro® (ertugliflozin) be made routinely available within the NHS for the treatment of adults with type 2 diabetes as monotherapy or in combination with Metformin.

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

WOMEN’S HEALTH

Endo breakthrough

M

DNA Life Sciences will launch the world’s first blood test for endometriosis, able to detect the disease in up to nine out of 10 cases.

The company says that results will be available days after the test is carried out, enabling doctors to make earlier decisions on diagnosis and treatment.

Using its proprietary technology, MDNA has developed techniques to exploit the unique characteristics of mutations in mitochondrial DNA, which can act as biomarkers for the presence of a range of diseases.

Pf View: Congratulations to MDNA Life Sciences for this breakthrough which we hope will enable women to receive an endometriosis diagnosis quicker than the average of 7.5 years reported by Endometriosis UK.

2/3

Pf IN NUMBERS

of MPs polled by WA Health believe the NHS should direct more resources to prevention. Prevention over cure? p14 year that PMCPA first 2011 The issued guidance on digital

communications. Connecting the world, p26

AMR

Resisting TB Roche has announced the CE-IVD launch of the cobas® MTB-RIF/INH test to detect resistance to antibiotics within tuberculosis DNA. This assay is part of the mycobacteria test menu that includes the cobas® MTB and cobas® MAI tests for use on the cobas® 6800/8800 Systems. This continues the expansion of the testing menu on the cobas 6800/8800 Systems, supporting true consolidation and efficient testing.

Tuberculosis is the leading cause of infectious disease deaths worldwide. The rising challenge of drug resistance compounds the tuberculosis global health crisis. The high sensitivity of the cobas MTB test enables increased detection of tuberculosis in challenging smearnegative samples.

A complete mycobacteria test menu provides the flexibility to detect a combination of tuberculosis, drugresistant tuberculosis and nontuberculous mycobacteria infections from a single patient sample. This provides important information for patient care decisions.

APRIL 2021

The date by which all of England will be covered by an Integrated Care System.

Changing the face of NHS commissioning, p22

R

CANCER.

MIND THE GAP

esearch by AstraZeneca has revealed that information on lung cancer can be difficult to access for patients and caregivers, is often outdated and sometimes inaccurate. The quality and accessibility of information varied considerably between the 11 countries studied, including the US, Japan, Canada, and across Europe and gaps in information were identified across all regions.

The analysis of 885 websites shows that although sources of information differed between countries, globally news sources were the leading type of website (42%). The research also shows that information on treatment options, when available, was often either too complex or too high-level and incomplete. Chemotherapy was the most frequently mentioned treatment option, included in 58% of sources, followed by radiation therapy (44%), surgery (40%), immuno-oncology therapies (38%) and targeted therapies (33%).

NHS

Making a choice A new poll by Populus has identified a lack of public awareness in choice of hospitals when accessing NHS treatment.

Populus interviewed 6116 adults online including 2314 who had been referred for an outpatient appointment by their GP within the last 12 months. It found that less than half of the public are aware that they can choose where they receive their NHS-funded hospital treatment despite the legal right to patient choice having been in place for over a decade.

While NHS England has committed to ensuring that by 2020 all patients are aware of the choices available to them when choosing their NHS treatment, just 48% of the public are currently aware of these legal rights.

Patients have the right to choose to be treated at a public or independent hospital in England with hospitals paid the same for the procedure.

The poll was undertaken by Populus on behalf of the Independent Healthcare Providers Network.

IMMUNOTHERAPY

IT’S A FIRST The National Institute for Health and Care Excellence (NICE) has issued a Final Appraisal Determination recommending the combination of Bristol-Myers Squibb’s Opdivo® (nivolumab) plus Yervoy ® (ipilimumab) to treat NHS patients in England with an advanced form of the most common type of kidney cancer, renal cell carcinoma.

This recommendation signifies an important landmark in the treatment landscape, representing the first approval of an immunooncology combination therapy for first-line patients with this type of cancer in England.

M AG A ZI N E | J U N E 2019 | 5

N

ew research into the link between Type 2 diabetes and cardiovascular disease risk highlights improvements in cardiovascular risk for women developing Type 2 diabetes despite gender-bias in prescriptions.

The Diabetes UK-funded study suggests that Type 2 diabetes leads to a smaller increase in the risk of cardiovascular disease (CVD) for women today than it has done in the past. Researchers at the University of Manchester studied data from almost 80,000 people with newly-diagnosed Type 2 diabetes, to look for differences between men and women in relation to their risk of having a cardiovascular event such as a heart attack or stroke.

Diabetes UK has also published a report saying that seven out of 10 people feel overwhelmed by the demands of living with diabetes.

Pf View: With around 4.7 million people living with diabetes in the UK, it’s great that research is being undertaken into links with other health conditions. For more information on diabetes, see our therapy article on page 28.

PRIVATE HEALTHCARE

Clarity required

DIABETES

FINDING THE LINK DIGITAL HEALTH

JOINING FORCES Digital experts are to join cancer and mental health teams as part of the growth of NHSX – a new joint organisation for digital, data and technology in the health service.

The digital and data specialists from NHSX will team up with NHS England’s cancer and mental health national policy teams to help clinicians and policymakers improve patient experience through technology.

The digital experts will support teams in: • making it easier for patients to access services through smartphones • giving clinicians access to the relevant diagnostic information about a patient • making it easier to collect and use health data which can benefit research and patients.

If this is successful it will be rolled out more widely across the NHS.

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

Following new information on private healthcare prices published by the Private Healthcare Information Network (PHIN), it is warning that medical fees are just one part of the total price of private healthcare, and that work remains to bring full transparency to fees and charges for patients.

Approximately one in four private healthcare procedures in the UK are people paying for their own treatment (self-pay), which is around 200,000 procedures per year.

The other 75% are covered by private medical insurance.

Consultants had to disclose their fees for self-pay patients after a Competition and Markets Authority (CMA) investigation found that the lack of transparency was unfair to consumers.

PHIN was appointed by CMA to collect fee data from consultants and began publishing that information online at the end of April 2019.

While progress is being made on clearer fees, and many providers now offer all-inclusive ‘package prices’ that bundle fees together, PHIN says more needs to be done for consumers.

PHIN’s data confirms that for initial and follow-up consultations, and many procedures, there is a premium to pay for treatment in London. Whereas cataract surgery, the most common private procedure in the UK, is most expensive in the South West, according to the data submitted to PHIN.

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NHS

NHS

ON THE RISE

Stop the cosh

A

study by health experts has shown that the productivity of the NHS has improved almost two and a half times faster than the wider economy over the last 12 years.

According to the University of York’s Centre for Health Economics, hard-working NHS staff provided 16.5% more care pound for pound in 2016/17 than they did in 2004/05, compared to productivity growth of only 6.7% in the economy as a whole.

The study, ‘Productivity of the English National Health Service: 2016/17 Update’, revealed NHS outputs have continuously increased since they began measuring 12 years earlier. Some 5.2 million more patients received planned or emergency hospital treatments in 2016/17 than in 2004/05 – an increase of about 42%.

Separately, outpatient activity has shot up by 131% since 2004/05, with over 60 million more attendances in 2016/17 compared to 2007/08.

Pf View: Despite immense pressure, NHS staff are still proving themselves to be incredibly hard-working for the benefit of patients.

Pf IN NUMBERS

4.7m £1.8bn

people live with Type 2 diabetes in the UK

An ‘army’ of health experts has been recruited by NHS England to help prevent care home residents being given too many medicines as charities voice fears that a generation of older people is being subjected to a ‘chemical cosh’.

The initiative is part of a package of measures to improve older people’s health and care in the NHS Long Term Plan.

The NHS is putting in place medical and clinical experts, including 200 new clinical pharmacists and pharmacy technicians, who will support care home residents to improve quality of life, cut hospital stays and reduce over-medication.

Care home residents are prescribed an average of seven medicines a day, with many taking 10 or more, costing the NHS an estimated £250 million each year.

The experts are working as part of a £20 million programme to reduce unnecessary medication of patients, to make sure that they are getting the right treatment that is being rolled out across the country.

Delving into diabetes, p28

The total funds earmarked to support Primary Care Networks Transforming primary care, p16

M AG A ZI N E | J U N E 2019 | 7

M

FLU

All the cells Influenza vaccine manufacturer Seqirus is to manufacture its cell-based influenza vaccine (FLUCELVAX® TETRA) using cell-based Candidate Vaccine Viruses (CVVs) for all four strains recommended by the World Health Organization (WHO) each season, making the entire production process cell-based.

The company will file data with the European Medicines Agency to support this decision as part of the 2019/20 Annual Strain Update requirement.

CVVs are provided each season by the WHO Global Influenza Surveillance and Response System (GISRS) and associated laboratories. The manufacturing seeds produced from these CVVs are used to grow large quantities of virus, in either eggs or cells, enabling the mass production of influenza vaccine matched to the WHO-recommended strains.

According to a recent study, which evaluated the degree of match of egg-based and cellbased CVVs to the circulating seasonal virus strain over the past 12 seasons, cell-based H3N2 CVVs have been more closely matched to the circulating virus than the egg-based H3N2 CVVs.

Pf IN NUMBERS

1.1bn

prescription items were dispensed in the community in 2018 Counting the cost, p9

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

MEDICINES DISCOVERY.

STATE OF THE NATION

edicines Discovery Catapult and the BioIndustry Association (BIA) have unveiled their ‘2019 State of the Discovery Nation’ report, providing new insights into the UK’s growing medicines discovery industry.

The report reveals a thriving service and supply sector for the UK in addition to its R&D biotechnology companies. It also highlights two breakthrough technologies set to influence the future of medicines discovery and maintain the UK’s global competitiveness, artificial intelligence and complex cell models.

The research found that service and supply companies account for 80% of small and medium enterprises (SMEs) in UK medicines discovery, and 90% of employment. While 20% of companies are actively focused on therapeutic product development.

With SMEs at the heart, UK medicines discovery is a large, diverse, vibrant and growing sector. This core biopharmaceutical sector alone increased turnover by £3.3bn and created 47 new businesses between 2016 and 2017.

CLINICAL TRIALS

In favour The Bristol-Myers SquibbPfizer Alliance has announced results from the Phase 4 AUGUSTUS trial evaluating Eliquis® (apixaban) versus vitamin K antagonists (VKAs) in patients with non-valvular atrial fibrillation and recent acute coronary syndrome and/or undergoing percutaneous coronary intervention.

Results show that in patients receiving a P2Y12 inhibitor with or without aspirin (antiplatelet therapies), the proportion of patients with major or clinically relevant nonmajor bleeding at six months was significantly lower for those treated with Eliquis® compared to those treated with a VKA.

PHARMA

YOU’RE THE BEST GlaxoSmithKline (GSK) has made the top five of the best companies in the UK to work for, according to the 2019 LinkedIn Top Companies list.

The list, which reveals the 25 companies where UK professionals want to work according to data compiled from employees on LinkedIn, placed GSK fourth.

Each year, LinkedIn’s editors and data scientists use a data-driven approach to identify the companies that not only attract the most attention from jobseekers, but also retain their employees. The data is compiled from what members are doing and saying in their search for a satisfying career, and reveals the most sought-after companies to work for.

In a separate accolade, GSK’s LGBT+ network, Spectrum, was voted best employee network group in the UK by Stonewall in 2019.

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T PRESCRIPTIONS.

ICYMI

COUNTING THE COST

IN CASE YOU MISSED IT

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

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

BEHAVIOUR CHANGE ON THE FRONTLINE OF PHARMA Never before has pharmaceutical sales been as competitive or as complicated. Prescribers are often spoilt for choice.

They have a plethora of entrenched preferences and habits. Regulations on what can and cannot be discussed are increasingly tight.

Understandably, this presents a significant challenge for pharmaceutical sales representatives at the pivotal point of brand launch. How will they be able to communicate effectively about new treatments so that patients receive the right ones and achieve the best possible outcomes?

Dr Pamela Walker discusses behaviour change on the frontline of the pharmaceutical industry.

he cost of prescriptions dispensed in the community and the number of items dispensed during the 2018 calendar year has been published by NHS Digital.

‘The Prescription Cost Analysis, England 2018’ report details the number of items and the Net Ingredient Cost (NIC) of all prescriptions dispensed in the community in England.

This includes all items dispensed by the NHS, except those dispensed in hospitals or on private prescriptions.

The NIC is the basic price of a drug excluding VAT and doesn’t consider any discounts applied.

The key facts in the NHS Digital report on the cost of prescriptions are: • In 2018, the cost of prescriptions dispensed in the community was £8.8 billion. A decrease of 3.7% (£336.6 million) from £9.2 billion in 2017 • In 2018, 1.1 billion prescription items were dispensed in the community. An increase of 0.3% (2.9 million) from 1.1 billion in 2017.

HOW PHARMA CAN PREPARE FOR BREXIT After Brexit, the EU will require all UKbased pharmaceutical businesses to have a physical presence in the European Economic Area (the EU plus Norway, Iceland and Lichtenstein), with an office/laboratory where tests are conducted to confirm standards have been complied with and where the paperwork will be securely kept for the European Medical Agency (EMA) to be able to go in and inspect.

In light of this, John Leyden shares the basic steps for pharmaceutical companies to take in order to be prepared for Brexit.

DEVELOPMENT OF BIOLOGICS: USING A HIGH-SPEED WORKFLOW TO GENERATE A PRODUCTION CELL LINE Biologics offer new therapy options for numerous diseases. They are already used to treat cancer and autoimmune diseases such as rheumatoid arthritis as useful alternatives to standard therapies. The extent of their market potential is revealed by the fact that the number of patent applications has been on the rise for decades now.

However, the route from the lab to mass production is much more complicated for biologics than for conventional drugs.

Dr Lars Kober shares UGA Biopharma GmbH’s expertise in the development of biologics: using a high-speed workflow to generate a production cell line. This article is an advertorial.

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

M AG A ZI N E | J U N E 2019 | 9

In pharma we trust?

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

C OV ER S TO RY

Pf Magazine, along with E4H, set out to survey healthcare professionals about the level of trust they have in the pharmaceutical industry. This is a snapshot in time survey which Pf will use as an annual benchmark.

WORDS BY Emma Morriss

I

t could be said that the pharmaceutical industry has a bad reputation amongst society. Known collectively as ‘Big Pharma’, recent mainstream media headlines don’t do anything to change that view.

Big pharma can only see the benefit of R&D for wealthy markets – The Guardian May 2019; Patients’ charity took cash from Big Pharma – The Times May 2019; Antibiotics aren’t profitable enough for Big Pharma to make more – Bloomberg May 2019.

However, what about healthcare professionals, those who interact with industry regularly? Do they have a different impression through their professional interactions? We set out to survey healthcare professionals to gauge their level of trust in the industry.

THE RESPONDENTS

The majority of respondents work in the NHS (84%) with fewer than one in 10 working in private healthcare. Of those who declared their field of work, nearly seven out of 10 work in primary care, just over one in 10 work in secondary care, a similar number work in community services, and the remaining respondents work in public health, tertiary care and voluntary sector. More than 90% of respondents are aged between 40 and 69.

INTERACTION WITH INDUSTRY

It’s clear that industry still believes in promoting products directly to healthcare professionals, with half of those surveyed saying that this is their primary interaction.

Whilst there is a proliferation of medical education opportunities open to the profession, four out of 10 surveyed are still accessing medical education with some support from industry, as this was the second most common primary interaction. This continues to be a key function for industry in supporting healthcare professionals to be at the forefront of treating patients effectively.

It is interesting to note that there was very little interaction with industry through R&D, which raises a number of questions, such as is industry-supported R&D in UK on the decline? Or is it that our survey did not reach out to those who are engaging in this activity with industry? Either way, this is a key point of leverage for the pharmaceutical industry that may not be being utilised to full effect.

We commonly hear of the decline of the sales representative in the UK, yet our survey says that four out of 10 medics interact with them to gain their information. A third engage with industry via digital methods such as websites, webinars, podcasts or online learning. The remainder of the interaction with industry is split between a variety of additional roles that industry now offers, including market access, customer services and medical scientific liaison.

M AG A ZI N E | J U N E 2019 | 11

TRUST IN INDUSTRY

Getting to the heart of the matter, when asked ‘Overall, I trust the pharmaceutical industry’, opinion is polarised.

Approximately a third agree, with very few who strongly agree, and a third disagree or strongly disagree with the statement. The remaining third are neutral.

There is no doubt that the pharmaceutical industry and medical profession have a crucial partnership, so why is opinion polarised on the issue of trust in the industry?

Does any other sector polarise opinion with its key partners that rely on each other so heavily? This has to be a real worry for industry and its trade organisations.

Regaining that level of trust must be a key priority. We know the ABPI has undertaken a number of activities to improve this.

Digging deeper into our analysis, approximately half of respondents think that some pharmaceutical companies are more trustworthy than others. Is it fair to assume that this is based on historical relationships?

When asked about personal experience of industry, 25% of respondents say personal history makes them trust industry more.

So, although digital is a growing channel to engage the medical profession, personal interaction and relationships are critical to building trust. This begs the question, what is the role of the sales representative?

Is it promotional or relationship building?

Or can both be achieved?

Pierre Van Weperen, Managing Director of Ashfield Healthcare UK, says pharma must change the way it communicates: “Building trust is about creating valuable interactions and real dialogue rather than just talking about a new drug and its applications. The pharmaceutical industry has to change the way it talks about drugs, healthcare professionals and the NHS, including medicines management. Clinical commissioning groups need to offer information in return about what they want and expect from treatments and how they define positive outcomes.”

Returning to the polarised opinion of industry, this is also reflected in responses to the statement ‘I trust the pharmaceutical industry to do the right thing for patients’.

Only 27% agree or strongly agree, and 30% disagree or strongly disagree.

Stephen Jowett, Country Lead, Health System Engagement at IQVIA, believes that

1 2 | P H A R M A FI EL D.CO.U K

the patient’s journey is key to building trust.

He says: “With the patient’s full journey at the centre, that pathway becomes the common denominator on which to build such trust and engagement to appreciate the mutual benefits of a deeper working relationship.”

When it comes to research and development (R&D) and clinical research, healthcare professionals have slightly better views of industry, with just under half trusting the industry’s R&D and one in five not trusting it.

There’s no doubt that industry’s investment in R&D and clinical research is valued and trusted by the health profession.

However, there is some concern that over 50% of respondents believe industry only publishes favourable clinical trial results, with just 4% believing this not to be the case. This is despite the ABPI’s commitment to transparency through its clinical trial disclosure toolkit.

When looking at the sales and marketing activities of industry, there is still work to do. A third of respondents say that these activities make them trust industry less, and only 15% say it makes them trust industry more. So how can sales and marketing activities be aligned to improve trust?

One area that is continuing to improve is regulation, as 40% say that industry regulation improves their trust.

Van Weperen added to this, saying: “Representatives are what they are – their role is to ensure that healthcare professionals

THE RESULTS

understand a product so they can use it effectively. With all the regulations and compliance requirements however, there is very little that representatives can do to avoid presenting data in an objective and balanced way. The ABPI Code of Practice has clear guidelines on what is allowed, guaranteeing that data is presented in the right way.”

CONSIDERATIONS

Is it important that industry is trusted by its key partner? We at Pf think it is. And we know the industry is one of the most regulated sectors with regard to sales and marketing (although self-regulated), so surely trust between industry and its key partners is critical to ensuring patients receive the best possible health outcomes. What can industry do to improve this?

Jowett shares his thoughts: “For trust to grow further between healthcare professionals and the life sciences industry, both need to work in a collaborative, transparent and sustainable way reflecting and providing insight to what the healthcare professional sees every day, in their hospital, clinic or surgery and in the geography where they work.”

Van Weperen adds: “In my opinion, the most important role that industry can play is adding value to how healthcare professionals can optimise patient care and outcomes, and that goes broader than talking about drugs and data. What are the key challenges for

ONLY

A THIRD OF RESPONDENTS TRUST THE PHARMACEUTICAL INDUSTRY

APPROXIMATELY

HALF OF RESPONDENTS THINK THAT SOME PHARMACEUTICAL COMPANIES ARE MORE TRUSTWORTHY THAN OTHERS

C OV ER S TO RY

ABPI: The regulator’s view

Pharmaceutical innovations have saved millions of lives in the hands of healthcare professionals.

Surely, we should be able to work together to continue that in the years to come

a practice, clinic or a clinical commissioning group and where can there be meaningful support? What else can be done to improve care and patient outcomes and how could other services, such as patient support programmes, objective patient audits, improving diagnosis and patient identification help? This is where the value lies and how trust will be built.

“Pharmaceutical innovations have saved millions of lives in the hands of healthcare professionals. Surely, we should be able to work together to continue that in the years to come.”

It’s clear from this survey that industry must try harder to build trust with healthcare professionals. We will run the survey again in 2020 to see if trust improves over the next 12 months.

G

iven the ABPI’s ongoing work on trust and reputation, we asked Jill Pearcy, Director of Code Engagement, for her thoughts on the survey results. She said: “People in industry and healthcare professionals both talk about the same goal equally passionately – to improve the lives of patients. It makes sense for industry and health professionals to work together to do that – so building our reputation is a top priority.

“93% of industry trials are published within 12 months – 96% overall. A BMJ study also highlighted that commercially sponsored trials are more likely to be published. We obviously have more work to do to make sure people know this.

“We are working on building trust in industry in a number of ways. Medicines pricing is a key element behind many people’s views of industry, so we have produced educational materials to help people understand the process of creating new medicines and the need to reinvest in new research.

“We are also constantly working on updating and raising awareness of our Code of Practice. If we can build trust in that, we can go a long way to improving our reputation with healthcare professionals overall.”

OVER 50% OF RESPONDENTS BELIEVE INDUSTRY

ONLY PUBLISHES FAVOURABLE CLINICAL TRIAL RESULTS

40% 25%

OF RESPONDENTS SAY THAT INDUSTRY REGULATION IMPROVES THEIR TRUST

Is it important that industry is trusted by its key partner?

We at Pf think it is

OF RESPONDENTS SAY PERSONAL HISTORY MAKES THEM TRUST INDUSTRY MORE

M AG A ZI N E | J U N E 2019 | 13

WORDS BY Caroline Gordon

Prevention Over Cure?

Interpreting the new political language of the NHS Caroline Gordon explores political attitudes to prevention in the NHS and the role of industry in prevention policy.

I

f you ever want to have a room of health chiefs and politicians nodding their heads in agreement, a good place to start is to talk about the benefits of early interventions, improving lifestyles and the ‘prevention agenda’.

Until fairly recently, prevention has been an agreeable sideshow in the politics of healthcare in the UK, separate to the more serious discussions about treatment.

While there has been talk in the past about ‘doing more on prevention’ to give it more strategic importance (not least as the first chapter in the Five Year Forward View), the past year has seen a distinct change in tone.

Since taking on the role as Sectretary of State for Health and Social Care, moving from his previous focus in culture and sport, Matt Hancock has been less effusive towards the life sciences industry than his predecessors.

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

POLITICS

In his first interview in the job, he told The Times newspaper that the old pharmaceutical tactics of calling on politicians to make the case for patient access would not be welcome.

He has repeatedly sung the praises of low cost, preventative interventions – gardening, choirs and Zumba classes – over pharmaceutical interventions, provoking endless headlines and articles on the merits of social prescribing.

While the noise around Brexit has dominated public attention in the last 12 months and more, the NHS will always be a hot political issue.

The NHS Long Term Plan, published in January 2019, backed up Matt Hancock’s enthusiastic embrace of the potential of prevention – which in Hancock’s view needs to be squarely seen as an alternative to medicine.

The Long Term Plan included new, specific measures such as the Primary Care Networks, aimed at making prevention mainstream, bringing it into the core business of the NHS, and setting out a clear challenge to the pharmaceutical industry.

Prevention is now seen by those close to the Secretary of State as something that will help the UK better manage and potentially reduce spending on treatment. In adopting this mindset, Hancock has started to invoke a new political language around prevention that puts it at odds with spending on pharmaceutical products. As a result, understanding prevention should now be a topic right at the top of the ‘to-do’ list of everyone working in healthcare government affairs.

A CHANGING POLITICAL LANDSCAPE

The 2012 Health and Social Care Act shifted strategic and spending decision making to the NHS itself, but politicians – whose inboxes and constituency surgeries are still full of voters’ concerns around local healthcare provision – still have a crucial role in setting the vision. Backbench MPs can often make all the difference when it comes to challenging government policy on medicines and health.

So – do the current crop of MPs agree with Matt Hancock that prevention is good and that we could be spending a lot less on treatment?

WA Health set out to poll 100 MPs from across the House of Commons on their views of the NHS Long Term Plan shortly after it was released. We wanted to discover the extent to which MPs backed the Long Term Plan, and in particular whether they would be in favour of a shift to prevention over treatment.

After all, it’s one thing to back an increase in spending on prevention, but quite another when it is openly at the expense of medicines spending.

POWER TO PREVENTION

Over the coming months, industry has a unique opportunity to set out its stall on prevention and show it can be a partner, not an adversary, when it comes to prevention policy

Nearly two-thirds of MPs we polled believe the NHS should direct more resources towards prevention, rather than increasing funding for new treatments. This finding shows that Hancock’s message is getting through to politicians from across the House. One in five MPs surveyed strongly agree with the sentiment of shifting more resources towards prevention, indicating that many may be willing to push the Government to go further in shifting focus away from treatment in terms of a purely preventative approach.

Through the NHS Long Term Plan (which our polling showed was overwhelmingly backed by MPs of all parties) that political support has evolved into tangible policy programmes that – if delivered as planned – could reframe the NHS around the prevention narrative.

PATIENT IMPACT

Of course, the funding pie for health spending is finite. Any money shifted from treatment to prevention could have consequences around patient access to life-changing medicines. But strikingly, when pressed if they would be concerned that a focus on prevention would lead to their constituents receiving a poorer standard of care, 43% of MPs surveyed stated they would not be concerned.

It is worth reflecting on this finding. MPs have a long history of campaigning for access to new treatments and their recent behaviour – vocally backing families of children waiting for new treatments for conditions such as cystic fibrosis or spinal muscular atrophy – shows this is still the case for MPs of all parties.

However, there may be a growing perception from MPs that more funding for prevention would automatically lead to a drop in treatment spending – although in truth, any savings would clearly not be realised for many years, if at all.

Furthermore, MPs may also conclude that spending on treatment ought not to be so high in the first place, so a reduction in favour of prevention would not necessarily equate to worse outcomes.

The pharmaceutical industry needs to make the case that without access to innovative new treatments, patient outcomes will be worse. What may seem a simple distinction for many in the industry, may not be immediately apparent to MPs. This is a challenge for industry, and one that healthcare communicators must overcome.

MIXED PRIORITIES

As prevention develops its own place in the political lexicon, it also needs to be better defined. Depending on who you ask, prevention can mean anything from careful therapeutic management through to expanding the sugar tax, and everything in-between.

These distinctions all come into play when spending decisions are being considered.

To better understand how MPs define prevention, we asked them to rank their most important prevention initiatives.

Perhaps unsurprisingly, their highest priorities focused on cutting obesity and improving physical activity. Preventative initiatives to improve mental health also ranked highly – particularly among the 2017 intake of MPs. Much lower priorities were genomic testing and predictive prevention, with just 27% of MPs choosing this option in their top three.

For industry, this again suggests that MPs view prevention in traditional terms – more aligned to the social prescribing model than the innovative opportunities that industry has played such an important role in. But it also makes clear that the language of prevention is still up for grabs.

Over the coming months, industry has a unique opportunity to set out its stall on prevention and show it can be a partner, not an adversary, when it comes to prevention policy. With the Government’s Prevention Green Paper just around the corner, now is the time for action. Caroline Gordon is Director of WA Health. Go to www.wacomms.co.uk M AG A ZI N E | J U N E 2019 | 15

INSIDE THE NHS

Transforming primary care

G

P practices have been urged to unite in new networks that will bring significant changes to the way primary care services are designed and delivered, under a new contract that begins in July.

Primary Care Networks (PCNs), which are each designed to serve 30,000 to 50,000 people, will see groups of GP practices collaborating locally with community services, social care and other health and care service providers.

A total of £1.8bn of funding has been earmarked to support PCNs and this money will come from Directed Enhanced Service (DES) payments, which are an extension of the core GP contract. To qualify for a slice of the funding, GP practices are required to join PCNs by June.

HOW WILL PCNS OPERATE?

Steve How and Oli Hudson explore Primary Care Networks, and their role in bringing together GP practices to help deliver integrated services.

WORDS BY Steve How

and Oli Hudson

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

PCNs are building blocks for the Integrated Care Systems (ICSs), which are expected to cover the country by April 2021 and will serve populations of one to three million people.

PCNs will help the NHS to deliver on one of its key priorities: to move care out of hospitals and into community settings, where possible.

Consequently, in addition to providing core GP services, PCNs will also deliver new services linked to NHS Long Term Plan priorities. Five of the new services will start

by April 2020, namely: • structured medication reviews • enhanced health in care homes • anticipatory care (with community services) • personalised care and • supporting early cancer diagnosis.

The remaining two: cardiovascular disease case-finding and locally agreed action to tackle inequalities – will start by 2021.

Seven workstreams, which are part of ICSs, will be layered on top of the DES-funded services, namely: • self-care and planned care • long-term conditions • frailty and end-of-life care • maternity and family • mental health • on the day care (emergency care) and • cancer.

MULTI-DISCIPLINARY TEAMS

In addition to GPs, PCNs will encompass clinical pharmacists, physician associates, first contact physiotherapists, community paramedics and social prescribing link workers. These staff will work across practices as part of a ‘network contract’ for the seven new enhanced services and help to free up GPs to focus more on patients with complex needs.

Multi-disciplinary teams in PCNs will also be instrumental in helping the NHS to deliver on its ambitions in key disease areas highlighted in the NHS Long Term Plan, such as respiratory conditions. The NHS Long Term Plan states that hospital admissions for lung disease have risen over the past seven years at three times the rate of all admissions generally and remain a major factor in winter pressures faced by the NHS. PCNs will help to tackle lung disease in a variety of ways. For example, pharmacists will conduct medication reviews and promote self-care by educating patients.

This will include advising on the use of inhalers since, according to the NHS, 90% of people use their inhaler incorrectly.

PCNs will also support the uptake of ‘new smart inhalers’, as clinically indicated.

ENGAGING WITH PCNS

TRANSFORMING PRIMARY CARE

It will, of course, be important for the pharmaceutical industry to follow the progress of PCNs as they take shape across England and to map the new customers who will be emerging. Industry also needs to map the new customers who will be working in ICSs and Integrated Care Partnerships (ICPs) which will serve populations of approximately 500,000 and will sit between ICSs and PCNs in the new integrated care hierarchy.

To engage with PCNs, the pharmaceutical industry must also understand how these organisations will be incentivised and measured. For example, all networks will have access to a new ‘shared savings scheme’ tied to reductions in hospital activity, such as accident and emergency attendances, delayed discharges and avoidable outpatient visits.

A PCN dashboard will be among the new initiatives for measuring performance. It will set out progress on network metrics covering population health, urgent and anticipatory care, prescribing and hospital use. Metrics for the seven new workstreams, which are part of ICSs, will also be on the dashboard.

To help PCNs deliver on their objectives, the pharmaceutical industry should consider how its products can deliver wider benefits across the whole care pathway, particularly with regards to keeping people out of hospital where possible. Industry also needs to consider the implications of the wider determinants of health, such as diet and fitness, since population health is a key priority for PCNs. In line with this, the pharmaceutical industry needs to define how relevant preventative interventions fit into patient pathways too and how it can support the NHS in delivering more proactive care strategies for particular cohorts of patients.

PCNs will pave the way for ICSs to be formed in every part of the country. They will also help the NHS to fulfil other key objectives outlined in the NHS Long Term Plan, particularly with regards to providing care closer to patients’ homes.

With the new contract due to begin in July, it will be essential for the pharmaceutical industry to understand what PCNs must achieve and how they will be incentivised and measured as they begin to transform the way that primary care services are designed and delivered.

Steve How and Oli Hudson are part of Wilmington Healthcare’s Consulting Team.

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

Primary Care Networks: Your new-look customer Integrated Care System

Primary Care Network

Medication Reviews

Personalised Care

Care Home Health

Early Diagnosis

Anticipatory Care

Disease Case Finding

Discover how we can help you engage with your new Primary Care Network customers.

E: info@wilmingtonhealthcare.com W: www.wilmingtonhealthcare.com T: 01268 495600

M AG A ZI N E | J U N E 2019 | 17

COACHING THE COACH Ian Robinson discusses how to provide structure to sequential in-call coaching to enhance customer excellence.

WORDS BY Ian Robinson

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

I

n the truly dynamic and innovative industry in which we are privileged to work, it’s easy to lose sight of some of the fundamental principles that have enabled us to positively impact the performance of our key brands over many years.

Customer excellence in the digital age means that organisations need to have a well-thought-out multichannel strategy, tapping into the customer’s preferred methods of communication in order to optimally deliver a relevant, credible and compelling brand narrative.

However, an enduring key lever within that strategy is the ability of the fieldbased employee to engage their customers in positive action for patients, ideally including the company brand as part of that solution. It’s the role of the First Line Field Manager (FLM) in growing and developing their team that, therefore, remains critical in delivering a consistent level of customer excellence as every suboptimal call is a missed opportunity for the business, and indeed for patients.

F E AT U R E

WHAT CHALLENGES DO FLMS FACE WHEN IN-FIELD COACHING?

There are many reasons to define what ‘good looks like’ in order to support FLMs beyond simply using the preferred coaching model that each is expected to rely on. Knowing how and when to coach can be a challenge. During a busy day in the field, the coachee may have a whole plethora of things to discuss with their FLM, ranging from business opportunities to help with administrative tasks and often personal issues outside of the work environment. Consequently, as a coach, manager, teacher, counsellor and mentor, FLMs need to wear several different hats over the course of the day and know when to wear each one appropriately. Moreover, given that infield coaching days typically only occur every four to six weeks, it’s imperative that time is allocated to focus on the development of specific skills that enhance the customer experience.

Therein lies the challenge for FLMs, in providing structure to ensure that this time is adequately protected to maximise the impact of coaching in-call skills. In addition, it can take time and several coaching visits to secure a skill at an agreed level, hence viewing coaching as a cycle of sequential events rather than a series of single interventions is key to accelerating and embedding customer excellence.

COACHES OFTEN DON’T RECEIVE COACHING THEMSELVES

LACK OF A CONSISTENT APPROACH

In 2013, during my time as a Second Line Manager, I decided to spend time observing three newly-promoted FLMs in my team who had been developed into those roles internally. It was fantastic to see the strengths that they each brought to the role; however, each were very different in style, specifically in how they approached in-field coaching days with their teams. This fired my curiosity as to how the more experienced FLMs within the team planned and delivered the same activities. Hence, I also invested time in observing them and again, each was quite different in their approach.

Whilst coaching styles will inevitably be individual, I was surprised at the variation in how each FLM set up the day and how they executed their coaching visits. There was no clear ‘good practice approach’ defined and whilst we had a set of key performance measures grounded in customer excellence, this was one that had been missed. Whilst I probably didn’t realise it at the time, it was a huge opportunity to raise the bar within our team and would certainly have provided an advantage versus our competitors had we taken the decision to invest time in defining good practice through a consistent framework.

Coaches often don’t receive coaching themselves, and most organisations don’t measure the true impact of coaching as a key performance indicator within their business

As I discovered a few years ago, FLMs typically follow the habits of the FLMs that managed and coached them when they were in individual contributor roles, so both good and not so good practices are transferred.

There is plenty of evidence available to highlight the fact that coaches often don’t receive coaching themselves, and that most organisations don’t measure the true impact of coaching as a key performance indicator within their business.

Linking up new FLMs with those that have significant experience can offer lots of benefits, however experience doesn’t always equal excellence, and the vast majority of FLMs won’t necessarily be consciously aware of their strengths and development opportunities as a coach. Therefore, there is a huge opportunity for organisations to support all their FLMs in identifying and working to establish an approach that enhances outcomes for the coachee and in turn, further promotes customer excellence within the business.

Those organisations that do establish an approach then have the advantage of being able to support and develop their FLMs to become the best in-field coach that they can be and to measure that progress in the quest for true customer excellence.

M AG A ZI N E | J U N E 2019 | 19

F E AT U R E

•

PRE-VISIT

PRE-CALL

Checking progress • Alignment on skills focus

Agree the standard • Practise the standard •

Repetitive cycle throughout the coaching visit

IN-CALL SKILLS COACHING STYLE

POST-VISIT

POST CALL

Agree action plan • Action plan follow-up • Support including remote coaching

Reflective coaching • Actual delivery versus agreed standard • Capture learning

•

•

WHAT DOES GOOD LOOK LIKE?

Fundamental to success is a clear and consistent framework that can be used to describe the optimal approach in order to measure progress and provide support and development for FLMs

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

Fundamental to success is a clear and consistent framework that can be used to describe the optimal approach in order to measure progress and provide support and development for FLMs. There are several tips and tricks that can be built into the framework that will add value and these can be considered as part of a pre-visit, pre-call, post-call and post-visit cycle. For example, agreeing a coaching contract with expectations from both parties pre-visit will generate clarity, accountability and bring focus to the discussions. It also creates an agreed platform to protect in-field coaching time whilst providing adequate time to cover any other business issues or opportunities that need to be part of the agenda for the day.

Preparing appropriately for the visit is also critical, both from a coachee and FLM point of view, with clarity on which specific skill or skills will be the focus for the day. This sounds obvious, however it is often overlooked and may result in the coaching being solely a post-call reflective activity rather than the optimal approach of effective pre-call coaching with an agreed standard for the skill, followed by the reflective review.

Furthermore, consistently acting on opportunities to coach post-visit is something that can significantly impact the ability of the coachee to retain and anchor a skill. It also means that FLMs can support their people remotely in order that calls with high priority customers are coached even when the FLM cannot be present. These are just a few simple examples of small changes to in-field coaching activity that can help FLMs deliver an enhanced experience for their people over a coaching cycle as part of a best practice framework.

It has taken me a good few years working with several organisations in our industry to realise the competitive advantage that I missed back in my time as a Second Line Manager.

Defining a standard that describes the ideal approach to in-call coaching and coaching FLMs to consistently deliver to that standard is certainly something that organisations should consider as a priority within their customer excellence focus. It could mean the difference between an average performance and a brilliant one. Ian Robinson is Managing Director of Pharmability Consulting.

Email: ian@pharmability.co.uk

A DV ERTO R I A L

“We help our clients perfect their value proposition to ensure it will add value and ultimately change behaviour”

60 SECONDS WITH ALVEO SOLUTIONS Creating a new standard for healthcare interactions to inspire behavioural change and engender trust. WO R D S BY Pete Hyde

M

any of our clients recognise that the relationship between the pharmaceutical industry and the NHS continues to decline. There has been a historical focus on activity levels over quality, and a desire to deliver a message ‘come what may’, rather than truly understanding the customer need. As a result, customers no longer wish to open their doors to people they perceive to be wasting their time.

A complete mindset change is required, and this is why we created Alveo Solutions – we are the first outsourced sales organisation with a mission to rebuild a sustainable channel between the pharmaceutical industry and the NHS, by focusing on high-quality customer interactions to create trusting and long-standing relationships.

THIS CAN BE ACHIEVED IN THREE WAYS:

1.

Only communicating with customers if you have something valuable to share

2.

Engaging with customers at a time and in a format that suits them

3.

Delivering excellence through all channels

You need to ensure that you have something that you truly believe is relevant and of value to communicate.

Focus on what problems you can help solve, rather than hitting call rates – a customer needs to end the call feeling satisfied that the interaction was truly useful and will make a difference to their practice.

At Alveo Solutions, based on our existing relationships and extensive experience, we help our clients perfect their value proposition to ensure it will add value and ultimately change behaviour. However, this can’t always be achieved and if the proposition really isn’t going to add value, we must remain true to our internal values and not blindly deliver a proposition which could negatively impact on our ‘hard earned’ relationships.

The chosen channel is crucial to ensure you are meeting the needs of your customer. The optimum channel choice can relate to the type of proposition you are communicating and the channel preference of the customer, which can vary from day to day.

To be able to successfully adapt, we have developed both remote solutions and an optimised face-to-face approach which offers a blend of channel choice.

In a ‘time pressured’ and heavily regulated environment, pharmaceutical sales professionals need to be able to communicate succinctly. It’s important to have conducted extensive research beforehand to ensure there is a complete knowledge of the environment, proposition and the stakeholder map within the account. Only then can a genuine key account approach be adopted to deliver true value.

In this day and age, we believe it’s important that companies take ownership to upskill their people to add value in every call, but equally as important is the skillset required to deliver effectively through all channels.

By addressing these three areas, we believe this will help to regain the trust of your customers, and rebuild a mutually beneficial and sustainable relationship.

You can contribute to the development of this new standard for healthcare interactions – contact Alveo Solutions to find out how we can optimise your engagement and rebuild your relationship with the NHS. Pete Hyde is Managing Director of Alveo Solutions.

Contact 020 7101 0697 or info@alveosolutions.com. Go to www.alveosolutions.com M AG A ZI N E | J U N E 2019 | 21

The changing face of

COMMISSIONING Sara Bainbridge explores the changing face of NHS commissioning with new policies, systems and legislation.

WORDS BY Sara Bainbridge

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

F

or anyone involved with the NHS in England, 2019 started with New Year’s Resolutions and a Long Term Plan. This set out some new priorities, restated old ones and provided some clarity for clinical commissioners.

Moving towards a more collaborative way of working – with ‘systems’ bringing together providers and commissioners – had been a theme of health policy since the advent of Sustainability and Transformation Partnerships in 2015. Through various iterations (and acronyms), it’s now clear that this approach is here to stay, as the NHS Long Term Plan set out that all of England will be covered

by Integrated Care Systems (ICSs) by April 2021.

This has implications for clinical commissioning groups (CCGs) – the local planners and purchasers of healthcare – as the Long Term Plan suggested there would be ‘typically’ one CCG for each ICS. Although we don’t know the final number of ICSs, nor how ‘typically’ will be applied, this does mean there are likely to be far fewer CCGs in 2021 than the 191 there are now.

INSIDE COMMISSIONING

AS THEY GET BIGGER, CLINICAL COMMISSIONING GROUPS ARE CONSCIOUS THEY NEED TO RETAIN THEIR LOCAL RELATIONSHIPS AND UNDERSTANDING

MOVING FORWARD

Now we’re halfway through the year, further publications have emerged which steer clinical commissioners further along the integration journey. NHS England and NHS Improvement, now a single organisation, published their proposals for legislative changes in the spring. These aim to overcome barriers to integrated working which CCGs and their provider counterparts might experience – amending the Health and Social Care Act to try to reduce the burden of procurement, share responsibility for health outcomes with other partners in a system, reform payment approaches and create joint decision-making committees, amongst other things.

Clinical commissioners are generally supportive of these changes as many of them reflect the issues they raised with us as the barriers to integrating. But changing legislation takes time and has no guarantees so efforts must continue to support CCGs to work collaboratively – which NHS England and Improvement (NHSE/I) have been doing through publications such as ‘Mechanisms for Collaboration’.

As mentioned, the recommendation for ‘typically’ one CCG per ICS still leaves some room for interpretation. But some CCGs are already taking steps to work at a larger scale – with many adopting joint working arrangements (as many share accountable officers) and discussing merging. NHS England published new guidance in April* for CCGs thinking about a formal merger. Any CCGs wishing to merge at the start of the next financial year would need their application to be approved by the national bodies in September.

But as they get bigger, CCGs are conscious that they need to retain their local relationships and understanding. Keeping in touch with their constituent ‘places’ or ‘localities’ is an important consideration for them and their local government partners, who often operate at this geographical level. Becoming the same size as an ICS might not be the best option for some CCGs so this recommendation must allow some flexibility.

More locally, Primary Care Networks are another new opportunity to fundamentally change the way healthcare is provided. They are set to cover the whole country in 2019, working at ‘neighbourhood’ level – for populations of around 50,000 people. They are being commissioned and approved by CCGs over the summer and will facilitate more multi-disciplinary team working between community and primary care.

TIMES OF CHANGE

What does this mean for those trying to get their heads around clinical commissioning? There is a lot of change, but it should be building on what has come before in terms of collaboration and joint working with local government and providers. CCGs are likely to reduce in number, working differently: for a larger population and more strategically.

Going through mergers is the next step for many but will mean they have to develop new organisations in parallel with getting on with the day job.

Ensuring all parts of their population can have the best opportunity for good health outcomes means they will continue to be making their crucial and often difficult decisions. Making these decisions should happen at the level that is most appropriate – at neighbourhood, place or system level – but will still be made by clinical leaders and with the perspective of trying to get the best value from the NHS pound.

Although the Long Term Plan came with a welcome injection of funds, there is still limited investment available for a growing and ageing population, so CCGs will be continuing to think about how to improve efficiency and manage the health of their whole population effectively.

SUPPORTING CCGS

This means NHS Clinical Commissioners’ work supporting CCGs to achieve best value will continue – we’ve worked with NHS England as part of its medicines value work, including consultations and guidance on items which should not be routinely prescribed in primary care and conditions for which over-the-counter items should not routinely be prescribed. We also know that CCGs struggle with growing spend on medicines and will, therefore, be advocating on their behalf on these issues.

BUSY FUTURE

The second half of 2019 is unlikely to see things calm down, as we could see draft legislation, each ICS publishing five-year implementation plans, and CCGs applying to merge. This comes alongside several anticipated set pieces from Government – a prevention green paper, the social care green paper and a spending review that should include a settlement for local government – all of which will heavily impact on CCGs and their work with others across health and care. Sara Bainbridge is Head of Policy and Delivery at NHS Clinical Commissioners. Go to www.nhscc.org

*www.england.nhs.uk/publication/procedures-for-clinical-commissioning-groups-to-apply-for-constitution-change-merger-or-dissolution

M AG A ZI N E | J U N E 2019 | 2 3

Stepping up Ben Osborn, Managing Director of Pfizer UK, talks transition and transformation in the pharmaceutical industry.

B

en Osborn is the recently appointed Managing Director of Pfizer in the UK. Having been with the company for 20 years, he knows it inside out, but isn’t afraid to make changes in this time of transformation in the UK, the NHS and life sciences.

Tell me about yourself I recently celebrated my 20th anniversary with Pfizer. I started as a graduate and have undertaken a wide variety of roles, both in the UK and internationally. As many do, I started as a sales representative, but I wanted to be at the heart of the action and decision-making and in two years, I moved into the head office.

I’ve had great support from Pfizer throughout my career, so when I received the call asking me if I wanted the role of Managing Director in the UK, it was an easy decision.

I’m married with three children. My eldest has a rare form of epilepsy meaning our family life has not been typical. My son wouldn’t be here without the NHS and industry, and I am reminded every day of what we do and why we do it. Our interactions with the NHS, social care and social services have given me an insight and understanding of our health system that many don’t have. In my spare time, I run. It’s my time to clear my head.

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

You became Managing Director of Pfizer UK in December, how is it going? It’s great; everything I expected it to be and a whole lot more. It’s both full-on and rewarding.

There are currently two things driving my role. Firstly, there’s so much happening in the UK; Brexit, ever increasing demands on our NHS, and the Government’s aspirations for a thriving life sciences sector.

Secondly, our new Chief Executive Officer, Albert Bourla, has brought a different feel and direction to the organisation. There is less emphasis on numbers and more on our purpose. We’re focusing on breakthroughs that change patients’ lives and everyone in the business has a part to play as we redefine Pfizer and its place in the healthcare sector.

There are exciting times ahead.

Developments in science, data and technology coupled with increasing expectations of our ageing population creates great opportunities to transform healthcare.

We need to follow the example set by disrupters such as Amazon, Uber and AirBnB and rise to the challenge to lead a step-change in how we approach healthcare.

Part of this is working differently. I’m trying not to be rushed. I’ve recognised where I can free up time to give the role and the organisation the due consideration it needs.

I have no scheduled meetings but meet people as and when needed. I think this will enable us to be more productive and take time to think and focus on what’s important. I am putting emphasis on personal energy and simplification so that we can work smarter as individuals and as an organisation.

What are your thoughts on the industry?

The healthcare issues of today and tomorrow can’t be solved in isolation. We must come together; industry, Government and the NHS, to address them.

The NHS Long Term Plan has set the direction for the future of our health service.

We share the ambition to have a world-class health service delivering world-class patient care and I believe we are aligned on ways to achieve that. We can support the NHS in driving health and wellness and delivering better preventative care; our vaccines and our work on antimicrobial resistance are just two examples of this. And by digitising our organisation, from drug discovery to the way we engage with our stakeholders and approach collaborative working with the NHS, we can support the NHS in becoming more efficient so that it can embrace innovation and improve patient outcomes.

The new Voluntary Pricing and Access Scheme presents opportunities too. Whilst it’s somewhat frustrating that spend on new medicines should be capped, the scheme brings important financial security to the NHS and provides mechanisms for new medicines and technologies to be fast-tracked to patients.

Time will tell if this happens; it’s been six months and we need to see action.

Brexit has prompted the UK Government to look at its sectors through a new lens.

Life sciences are very productive for the Government and society and should be viewed as the jewel in the crown of sector deals. We need to work together with the Government to look at how best to bring together early phase research and development, clinical trials and regulation to develop an ecosystem that gets medicines to patients quickly.

COFFEE BREAK

What opportunities are there for industry?

Government’s interaction with Pfizer, and industry as a whole, around Brexit has been open, clear and candid. We have come together to build plans and find solutions to evolving challenges at pace. It has been an unprecedented situation, but if we can come together in this way for the wider benefit of life sciences and pharmaceuticals, we could achieve great things.

One area we’re focused on is how we can move from a volume-based to a valuebased economic model so that industry is measured and compensated based on patient and societal outcomes. The UK has a real opportunity to lead the way on this and by working together with Government we can explore new ways to ensure patients can really benefit from innovation. We have already built partnerships with the NHS and local authorities to develop outcomes-based initiatives and we’re looking at care pathways and how we can free up capacity for the NHS and create a better experience for the patient.

been undertaking work which benefits society at a different level. For example, our recent exhibition on superbugs at the Science Museum in London had over 1 million visitors, and if it changes behaviour around antimicrobial resistance, it’s worth it. We also run a schools’ programme for primary and secondary school students which educates them about our industry and how medicines are made. We hope to inspire a younger generation of scientists to pursue careers in science, technology, engineering or maths whilst at the same time educating them about important topics such as counterfeit medicines.

Putting patients first is at the core of our culture. In everything we do and every business decision we make, we always need to consider; do we know what patients think or feel about this? Does this meet their needs and make a positive contribution to our society? And if the answer isn’t yes, we challenge ourselves to think again.

Go to www.pfizer.co.uk

We’re focusing on breakthroughs that change patients’ lives

INTERVIEW BY Emma Morriss

What are your thoughts on NHS/industry collaborative working? I firmly believe that we’re in a new era of industry/NHS partnership, but it needs to be built on trust from both sides. We need to move industry from being a transactional supplier to a collaborative partner, and through this renewed relationship we can ensure the long-term sustainability of the NHS. At Pfizer, we have around 230 research collaborations in the UK, from traditional clinical trials to patient- centred partnerships. No one person or organisation has the resources, mind- power or capacity to solve the NHS’s problems – we need to work together.

What is Pfizer doing in the drive to put patients first? We’re trying to think differently about our contribution to patients and society. It’s not just about the medicines we make. We’re passionate about playing an active role in our community and have

M AG A ZI N E | J U N E 2019 | 2 5

WORDS BY

Rina Newton

Connecting the world Rina Newton offers guidance on the use of LinkedIn and the ABPI Code of Practice.

T

he Prescription Medicines Code of Practice Authority (PMCPA) has received at least nine complaints to-date about the use of LinkedIn, indicating that its use, which is not specifically addressed in the ABPI Code of Practice (Code), may benefit from guidance on how to adhere to existing principles whilst also respecting the purpose of LinkedIn. This should help ensure the LinkedIn accounts and activities of pharmaceutical companies and pharmaceutical/agency employees, comply with the Code.

LinkedIn’s mission is to ‘connect the world's professionals to make them more productive and successful’.

Fundamentally, the PMCPA has noted that LinkedIn is different to other social media platforms; it is ‘primarily, although not exclusively, associated with an individual’s professional heritage and current employment and interests’.

However, in terms of the Code, the word ‘professional’ does not sufficiently differentiate LinkedIn from Twitter or Facebook. Therefore, the Code principles for social media are applied broadly.

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HOW THE ABPI CODE APPLIES TO LINKEDIN It is acceptable for pharmaceutical company and agency employees to use personal LinkedIn accounts, but their posts might be covered by the Code and the company held responsible for any breaches. The PMCPA has stated that this is decided on a ‘case by case basis taking into account all of the circumstances including the nature of the material disseminated, any product references, the company’s role if any in relation to the creation or availability of the material posted, whether such posting was directed, encouraged or otherwise acquiesced to by the company. The status and role of the employee might also be relevant.’

Therefore, it is a good starting point to consider broadly when the Code applies (eg promotion or disease awareness) and does not apply (eg recruitment).

WHEN THE ABPI CODE APPLIES TO LINKEDIN UK company posts and articles about medicines and therapy areas always fall under the scope of the UK Code.

Non-UK company posts and articles will fall under the scope of the UK Code only if: • Global/International/EU companies, and therefore LinkedIn accounts, are based in the UK • The UK pharmaceutical company or agency employee shares/likes a non-UK post that relates to the commercial or professional interests of the company.

Non-pharmaceutical posts and articles will fall under the scope of the UK Code if: • The content relates to the commercial or professional interests of the company and the UK pharmaceutical company or agency employee shares/likes the post.

ABPI

Whilst it is true to say that applying the existing principles of the Code to LinkedIn activity goes some way in preventing issues, there is a need for specific guidance on the appropriate use of this particular platform

If a UK company is liable under the Code, the usual breaches are: • Promoting prescription-only medicines to the public • Not certifying non-promotional material for the public • Promoting to health professionals without obligatory information or certification • Promoting pre-licence medicines • Failing to tailor information to the audience • Failing to obtain permission to promote via ‘electronic’ means.

Furthermore, the absence of clear and unambiguous company guidance may result in breaching ‘high standards’, but the complete absence of a compliance infrastructure will likely breach Clause 2 (‘bringing discredit upon the whole industry’).

UNDERSTANDING PROMOTION UNDER THE ABPI CODE Whilst many of the LinkedIn cases relate to unacceptable promotion, the learning here has more to do with poor knowledge of what ‘promotion’ is, rather than how LinkedIn is used.

Recently, when asked about a UK employee sharing a US post about a company’s pipeline medicine, a senior director responded: “The data is all in the public domain and has been communicated at an EU congress.”

This may be true, but the UK employee’s share of this US post brings the post under the scope of the Code, and disseminated material that promoted the medicine to their followers, some of whom would have been the public and health professionals, without proper UK approval.

A top line solution to this situation would be if the UK arm of the company had amended and approved this information before posting it on their own UK account for all their followers to read. This would then have allowed any UK employee to like/ share the information. Alternatively, the use of closed groups provides an opportunity to communicate relevant and meaningful content with appropriate audiences.

TOO MUCH OR TOO LITTLE A less obvious risk to counter ‘too much social media’ is, of course, too little. A pharmaceutical company with little or no LinkedIn activity but with active employees, can sometimes lead to employees sharing inappropriate information.

For example, a senior NHS clinician was working in the pharmaceutical industry in his speciality field. In the absence of his company posting news, he considered it appropriate as a health professional to post news on LinkedIn about recent advances in his field. In failing to appreciate that his new ‘pharmaceutical employee’ status required complete adherence to the Code, he put his company at risk. A disclaimer about ‘mine and not my employer’s view’ would not suffice in this regard.

Had the UK company posted an approved post about the recent advances, not only could UK employees like or share this but, importantly, this would have allowed wide communication of scientific progress.

In these examples, the availability of clear company guidance could have provided some infrastructure.

GUIDANCE ON LINKEDIN AND THE ABPI CODE In terms of other available advice, the British Medical Association and Royal Pharmaceutical Society both provide guidance to their members about social media, ethics and professionalism (in relation to patient confidentiality, content of communications and professional boundaries).

The PMCPA first issued guidance1 on ‘digital communications’ in April 2011 which is largely the same in 2019 and does not mention LinkedIn. The ABPI convened a meeting in January 2018 to discuss what might be needed in social media guidance, however, none has been provided yet.

Whilst it is true to say that applying the existing principles of the Code to LinkedIn activity goes some way in preventing issues, there is a need for specific guidance on the appropriate use of this particular platform.

Our suggestions for such guidance are included on the right.

What could be included in guidance on LinkedIn for the UK pharmaceutical industry?

• Strategy • Recommended content for company policies and contracts with third parties • Recommended training scenarios for initial and ongoing awareness • Type of LinkedIn content to which the UK Code applies (profiles, posts, articles) • LinkedIn functionality (settings, likes, shares, groups) • Liability for comments (posts, articles, groups) • Approval of LinkedIn communications (certification, examination, final form) • Recall of LinkedIn communications (or reapproval) • Adverse event reporting • Use of closed groups (permission, link to prescribing information) • Oversight and monitoring.

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

Cases AUTH/2851/6/16, 2738/10/14, 2988/10/17, 3038/4/18, 3019/2/18, 3020/2/18, 3021/2/18 and two cases not yet in the public domain Social media, ethics and professionalism guidance (BMA) https://www.bma.org.uk/advice/employment/ethics/social-media-guidancefor-doctors Social Media: Ethical and professional challenges (RPS) https://www.rpharms.com/resources/toolkits/social-media-guidance/ social-media-ethical-and-professional-challenges PMCPA guidance on digital communications (March 2016) http://www.pmcpa.org.uk/advice/digital%20communications/Pages/default.aspx

M AG A ZI N E | J U N E 2019 | 27

TYPES OF DIABETES There are two main types of diabetes: Type 1 and Type 2. Although both relate to high blood glucose levels, they are different conditions. There are also a number of rarer types.

TYPE 1 DIABETES

Type 1 diabetes occurs when the pancreas cannot make insulin to regulate blood glucose levels and transport glucose from the blood and into cells. The cells in the pancreas which produce insulin, beta cells, are attacked by the immune system causing the body to be unable to produce insulin, leading to Type 1 diabetes.

As a result of the body not being able to produce enough insulin, people with Type 1 diabetes need to take insulin regularly by injections or through a pump.

According to Juvenile Diabetes Research Foundation Ltd (JDRF), the reasons why the immune system attacks and destroys beta cells are unknown, yet around 330,000 people in the UK have Type 1

diabetes and over 29,000 of them are children. JDRF says that incidences of Type 1 diabetes are increasing by 4% each year and particularly in children under five, where there has been a 5% increase each year over the last 20 years. Around 90% of people with Type 1 diabetes have no family history of the condition.

TYPE 2

TYPE 1

1 or 2?

Delving into diabetes Diabetes is a serious health condition and there are two main types: Type 1 and Type 2. How do they differ and what treatments are available?

WORDS BY Emma Morriss

Diabetes is a major health condition in the UK. New figures from Diabetes UK highlight that 4.7 million people in the UK now live with a type of diabetes, and one in 10 over 40s has Type 2 diabetes.

It estimates that 5.5 million people in the UK will have diabetes by 2030.

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THERAPY AREA

TYPE 2 DIABETES

Diabetes UK says that around 90% of people with diabetes have Type 2. It is estimated that approximately 3.8 million people in England have diagnosed or undiagnosed Type 2 diabetes, with over 200,000 people in England being diagnosed each year.

Unlike Type 1 diabetes where the body’s immune system attacks the insulin producing cells, in Type 2 diabetes the body does produce insulin but not enough, or the insulin it produces does not work properly. This creates a cycle where the insulin doesn’t work properly so the pancreas tries to produce more, and glucose levels continue to rise.

NHS.UK says that a person is at more risk of developing Type 2 diabetes if they are over 40, or 25 for south Asian people; have a close

LESS COMMON TYPES OF DIABETES

relative with diabetes – such as a parent, brother or sister; are overweight or obese; or are of south Asian, Chinese, African Caribbean or black African origin – even if they were born in the UK.

Not managing high blood glucose correctly can lead to people experiencing serious health complications

SYMPTOMS OF DIABETES

The symptoms of Type 1 and Type 2 diabetes are similar because they stem from the body being unable to remove glucose from the blood. However, the symptoms of Type 1 can come on rapidly.

Needing to urinate more often is a key symptom as the body tries to remove the glucose via the urinary system. Other symptoms include excessive thirst, tiredness, weight loss, and frequent bouts of thrush.

Symptoms can also show themselves as blurred vision, delays in cuts healing, or increased appetite.

Both Type 1 and Type 2 diabetes are diagnosed with blood tests to check blood sugar levels.

If blood sugars get too high, a person may have hyperglycaemia or a hyper. Like the initial symptoms of diabetes, hypers can be characterised by needing to urinate more frequently, excessive thirst, tiredness and headaches.

Some treatments for diabetes such as insulin can drop blood glucose levels too low. If someone has particularly low blood sugar, they may have hypoglycaemia, or hypos. Symptoms can vary, however, they are typically characterised by feeling shaky or sweaty, having a fast pulse, going pale, feeling anxious, irritable or emotional, being hungry, having blurred vision, a lack of concentration, tiredness or headaches.

DIABETES POLICY

In 2017, following campaigning by Diabetes UK in partnership with people living with diabetes, NHS England announced a £44 million Diabetes Transformation Fund to drive improvements in diabetes treatments and care for people with Type 1 and Type 2. The treatment and care programme built on the prevention work which was already underway.

The ‘Healthier You: NHS Diabetes Prevention Programme’ is a joint commitment between NHS England, Public Health England and Diabetes UK. It focuses on people at high risk of developing Type 2 diabetes and refers them to a behaviour change programme,

Beyond Types 1 and 2, there are other, less common types of diabetes.

• Gestational diabetes affects pregnant women in their second or third trimester and usually goes away after giving birth. It occurs when pregnancy hormones affect the body’s ability to use insulin properly.

• Type 1.5 diabetes or latent autoimmune diabetes in adults (LADA) has elements that are the same as Type 1 and Type 2.

• Neonatal diabetes is diagnosed in children younger than six months.

• Maturity onset diabetes of the young (MODY) is a rare type of diabetes that has a strong genetic link as it is caused by a gene mutation.

• Wolfram Syndrome and Alström Syndrome are also rare genetic conditions.

including education on healthy eating and lifestyle, help to lose weight and bespoke physical exercise programmes. NHS England says that five million people in England are at high risk of developing Type 2 diabetes and Type 2 diabetes treatment already accounts for just under 9% of the annual NHS budget, around £8.8 billion a year.

Most of the spending is on complications which can be reduced by improved treatment and care for people with Type 1 and Type 2 diabetes. Further funding and commitments on Type 2 diabetes prevention and diabetes care and treatment were made part of the NHS Long Term Plan.

TREATMENTS FOR DIABETES

People with Type 1 diabetes need to inject themselves with insulin or use an insulin pump to control their blood glucose levels.

There are different types of insulin: long-acting or fast-acting.

As the names suggest, long-acting insulin keeps working for a long period of time, meaning it can work overnight or throughout the day. By contrast, fast-acting insulin is taken just before the person eats. It helps to control blood sugars so they don’t spike (increase rapidly) around mealtimes.

People with Type 2 diabetes may also require insulin, however, lifestyle changes such as healthy eating and exercise, coupled with drugs to help lower blood sugar levels if necessary, are usually the first line in controlling the condition.

Some people with diabetes need to monitor their blood glucose levels to check when they need to take their medication. This can be undertaken by a finger prick test and a blood testing meter and may be completed first thing in the morning, before or after meals depending on the type of diabetes.

Not managing high blood glucose correctly can lead to people experiencing serious health complications such as problems with their sight or feet. In extreme cases, people may go blind or require an amputation. This is due to a build-up of sugar in the blood which impedes the flow of blood around the body.

M AG A ZI N E | J U N E 2019 | 2 9

THERAPY AREA

KEY FACTS

Through exercise, diet and medication my blood sugar control is great, and I feel fit and healthy

4.7

MILLION PEOPLE IN THE UK HAVE DIABETES

Being LADA

There’s a third type of diabetes which not many people know about. Here’s Graham’s story.

G

raham’s twin brother was diagnosed with Type 1 diabetes at the age of 15. Two decades later, in 1999, Graham was wrongly diagnosed with Type 2. Four years after that, he was told that he might have a third type of diabetes: LADA (Latent Autoimmune Diabetes of Adulthood) or Type 1.5.

“When my twin brother was diagnosed none of us knew what diabetes was or its impact or knew anyone who suffered from the condition. He had to go straight into hospital and I remember being really scared for him. Being twins, we were really close.

His regular hypos seemed to control his life. Back in those days there was no human synthetic insulin; it was pig’s insulin that kept him alive. Before each meal, he would draw up the insulin from a vial into a heavy metal and glass syringe which had to be cleaned before every injection.

His diabetes affected us all. It was hard on my mum, she had a steep learning curve, what he could and could not eat, the weighing out of all his food and new low sugar and carb recipes to manage his condition. We didn’t always get it right of course, but as a family we gradually learned to adapt to our new routine.

Not long after my brother’s diagnosis, we were contacted by Kings Hospital in Denmark Hill. They were interested in undertaking tests on us to help with their research.

Having one twin with diabetes and one without was gold dust for medical research.

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We took almost annual trips to hospitals in London for tests. But as the years went by, the odds were in my favour, I was no more likely to develop the condition than the general population.

So it came as a bit of a surprise when during a regular check-up the doctor bluntly told me I had Type 2 diabetes. I was prescribed gliclazide and a controlled diet.

Four years after my diagnosis, Barts Hospital got in touch to say that they thought I may have a new type of diabetes that hadn’t been previously identified; LADA, unofficially known as type 1.5.

LADA is difficult to identify as there isn’t as much information about it and there isn’t really a test for it beyond being diagnosed with diabetes. The medication is very much ‘try it and see what works’ rather than anything more empirical. My medication must be regularly reviewed.

Currently I control my sugar levels through a combination of long acting insulin (Tresiba) and a small amount of short acting insulin (Nova Rapid) with my meals. I take the same dosage every day and only change this following consultation with my doctor.

Overall I feel very lucky. Through exercise, diet and medication my blood sugar control is great, and I feel fit and healthy. I still enjoy riding my bike and competitive cycling and can honestly say I don’t feel diabetes stops me doing anything in my life.” With thanks to Diabetes UK. Go to www.diabetes.org.uk

90%

OF PEOPLE WITH DIABETES HAVE TYPE 2

AROUND

330,000 PEOPLE IN THE UK HAVE TYPE 1 DIABETES

OVER

29,000 CHILDREN IN THE UK HAVE TYPE 1 DIABETES

5.5 MILLION PEOPLE IN THE UK WILL HAVE DIABETES BY 2030

£8.8 NHS SPENDS

BILLION

ON TYPE 2 DIABETES TREATMENT EACH YEAR

Sources: Diabetes UK, JDRF, NHS.UK, NHS England

one million step

challenge

Step it up this summer towards a healthier you Take one million steps between 1 July and 30 September 2019 and raise money for people living with diabetes.

Search One Million Steps or go to www.diabetes.org.uk/step-pf Diabetes UK is the operating name of the British Diabetic Association. Company limited by guarantee.

Registered in England Wells Lawrence Diabetes UK is the operating nameno. of 339181.Registered the British Diabetic office: Association.

CompanyHouse, limited by 126 Back Church Lane,inLondon 1FH. A charity registered in England and Wales (215199) guarantee.

Registered EnglandE1 no.

339181.Registered office: Wells Lawrence House, and in Scotland Š Diabetes 2019 registered 1553FB in England and Wales (215199) 126 Back Church(SC039136).

Lane, London E1 1FH. UK A charity and in Scotland (SC039136). Š Diabetes UK 2019 1553F

IT’S ALL ABOUT EXPERIENCE Communicating with your customers

Magnus Franzen explains why customer experience management is essential to delivering what your customers need.

C

ustomer experience management (CXM) is both a discipline and a philosophy.

As a discipline, it is a way of operating and a continuous improvement process focused on the experience that a customer has in dealing with a company. CXM has five main components, as listed opposite.

The first, purpose and strategy, is essentially an articulation of why a company exists, and what role it has in the life of its customers.

Design is about starting to see experience and the journey that customers are on as something a company can intentionally design. It doesn’t just happen.

Operations are all the plumbing and back-end infrastructure that is needed to support the design.

People and culture are all the complex and tricky stuff that actually work as the glue that keep all the operational pieces together.

In fact, the engagement and motivation of employees is a critical piece of the CXM philosophy, to deliver great experience.

Happy employees make happy customers.

Measurement and governance are the fifth and final component. As the saying goes, ‘what isn’t measured can’t be managed’.

And inherently, managing the experience is what we want to do in CXM.

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MARKETING

MAIN COMPONENTS OF CXM 1 2 3 4 5

Purpose and strategy Design Operations People and culture Measurement and governance

A very common way of measuring is called Net Promoter Score, which measures customers’ propensity to recommend the company to a friend. This is a simple score which in its simplicity has both strengths and limitations. Its main strength is that it works very well for benchmarking. You can compare yourself against competitors or companies in other industries. It is also quite limited as it sometimes has emotional connotations which can be problematic in the pharmaceutical industry (that is, recommending someone to buy a similar phone to yours is not the same as recommending they try out a life-saving treatment or choose one insulin over another).

From a philosophical point of view, CXM is about understanding three things: • People buy experiences and the ability to get a job done, they don’t buy products • People that have good experiences become more loyal to the company than people that have bad experiences • Loyal customers drive value for the company.

If you buy into these three things, the importance of taking a structured approach to managing your customers’ experience becomes self-evident.

To get more practical, it is difficult to know where to start – we know that. In fact, many companies we work with struggle with getting started because they don’t know what they are not doing and where they need to improve.

As I mentioned, we have a framework that looks at the main component of a functioning CXM capability and helps companies assess themselves to identify the maturity of their different components. From there, it is easier to determine what weaknesses to improve and what areas of strength to build on.

I find it quite helpful to see this as a continuous improvement process. Rome wasn’t built in a day and amazing experiences are not conjured up quickly. It takes time and effort. On top of that, customers’ expectations are constantly evolving. In the age of Amazon and Apple, people (and yes, customers are always people) are expecting a similar level of customer experience in every part of their lives.

In the same way, the pharmaceutical industry’s customers’ expectations have evolved, while the industry has stood still.

Therefore, it is important to take a structured approach, build your CXM ‘maturity’ over time and continuously improve the experiences.

DELIVERING CUSTOMER VALUE ON A DAILY BASIS

Delivering customer value on a daily basis depends on a number of things; the company, the portfolio, the customers and stakeholders involved in treating the condition, the condition itself, and so on. However, by becoming more customer-centric, you start to think about experiences and helping customers to get jobs done rather than thinking about products and brands. This means that you begin to understand who you, as a company, are serving and what role you want to play in their lives. These form a really good starting point.

The ‘how’ will come as a result and it will look different in every situation.

Across all industries, companies that focus on customer experience and get good at it see substantial returns

WORDS BY Magnus Franzen

BENEFITS OF CXM

Across all industries, companies that focus on customer experience and get good at it see substantial returns. They outperform their competition in revenue growth, profit, customer loyalty, employee satisfaction – you name it. In fact, I believe companies should be asking themselves ‘what is the risk if we do not start thinking about the experience of our customers?’.

For example, one company has started to look at CXM and in one meeting they explained that they have never had to do anything about this before. They have had an amazing drug which has completely outperformed other treatment options for several years. They didn’t have to do anything, the drug sold itself. However, today it looks different: the competition has caught up, new drugs in the pipeline don’t have the same differentiation and so on. Our question to them was ‘what will you do now? How will you be relevant to your customers? Why should a customer choose you now?’.

CHANGE MANAGEMENT

In order to implement these changes, support and recognition amongst senior leaders is a priority and a crucial starting point. Then it comes down to fairly standard steps of change management: • Define the burning platform and case for change • Set the vision (which in our CXM framework is a lot about strategy and purpose) • Get the right people on board (it’s often a broader stakeholder group than you think) • Build the capabilities, create the governance, align incentives etc • Show the quick wins.

The proof of the pudding is in the eating, of course. The methodology at a high level might be quite standard, but every organisation is different and what is actually needed might be quite different.

COMMUNICATING WITH CUSTOMERS

There is no need to find new ways to communicate the same old thing. Start with your customers, figure out what value is to them, then think about what you can do to provide that value. Then, and only then, start thinking about the channels through which you will provide the value.

Magnus Franzen is a Management Consultant at PEN CX. Go to www.pencx.com M AG A ZI N E | J U N E 2019 | 3 3

Ideally, no matter which pharmacy patients visit, they should receive a high level of standardised care from a qualified health professional

First contact WHY WE NEED COMMUNITY PHARMACY MORE THAN EVER Dr Zubair Ahmed discusses the important role the community pharmacy plays in the sustainability of healthcare.

WORDS BY Dr Zubair Ahmed

W

orking as a GP, I saw first-hand how the traditional model of primary care was struggling.

The broad challenges faced by the NHS, including a shortage of GPs, surgery closures and an ageing population with more complex disease, have increased the pressures on the NHS. Ultimately, this has led to problems with access to primary care; with patients struggling to get appointments when needed.

IMPORTANT ROLE

In these difficult times, it becomes increasingly clear how important a role community pharmacy plays in supporting the public’s health with quality, accessible care. With all of the challenges facing primary care, there are many opportunities arising for community pharmacy.

According to NHS England, as many as 30 million consultations in GP practices could be delivered in a different setting. One such setting is the often-undervalued environment of local pharmacies, offering convenient access to trained healthcare professionals.

There are over 11,500 community pharmacies in England, each serving around 5,000 people. Unlike GP practices, pharmacies often benefit from being situated in convenient high street locations.

Furthermore, pharmacies are generally open longer than GP surgeries, with many open well into the night and on public holidays.

This provides unparalleled access to a trusted healthcare setting.

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PHARMACY

WIDE RANGE OF SERVICES

PATIENT EXPERIENCE

This convenient access to a health professional can be very appealing, especially to patients who have become accustomed to the immediacy of modern services like Amazon, Uber and Netflix. Improving access has the ability to improve overall health outcomes by picking up disease earlier, decreasing strain on other parts of the health system and better managing chronic disease. For example, 1.2 million people with asthma don’t get an annual asthma review which contributes towards 800 avoidable deaths per year. Providing on-demand, convenient and accessible asthma reviews will only help this problem.

Community pharmacies can offer so much more than a channel for the dispensing of medicines, and patients are beginning to recognise this. For many years, pharmacies have increasingly been commissioned to deliver a wide range of services, including NHS Health Checks, smoking cessation, vaccinations, substance misuse services, sexual health screening, emergency contraception and many more. Over 80% of all pharmacies have been accredited as Healthy Living Pharmacies (HLPs), largely due to the scheme being incentivised with an NHS England Quality Payment.

Another obstacle faced by community pharmacy, however, is that the patient experience can vary significantly depending on which pharmacy a patient goes to and when they go. While some pharmacies have independent pharmacist prescribers and can give a lot more advice, some other pharmacists have limited expertise and are not confident managing some clinical presentations. This lack of standardisation can hurt the agenda of making pharmacies the frontline of healthcare as patients are left confused as to what can and can’t be done from a pharmacy as the patient may refer back to their NHS GP surgery questioning the capabilities of a pharmacy.

This highlights a need to make the patient experience more consistent in community pharmacy. Ideally, no matter which pharmacy patients visit, they should receive a high level of standardised care from a qualified health professional. One solution to this is a nationwide training scheme and provision of facilities.

Alternatively, community pharmacies can also take advantage of new developments in health technology to help level the playing field. With telemedicine, pharmacies could use a pool of prescribing pharmacists and GPs to deliver a consistently high quality of care, no matter which pharmacy a patient walks into at whatever time of the day or night.

UNDER-UTILISED RESOURCE

There is increasing evidence to show that community pharmacy is still being under-utilised. For decades, the NHS has tried to encourage people to visit their local pharmacy rather than their GP practice, with limited success. Far too many people use GP surgeries to treat conditions which could be swiftly managed at their local pharmacy by a skilled staff member, including pharmacists, pharmacy technicians and Health Champions.

Raising awareness of what a community pharmacy is able to do is crucial to overcoming this challenge. GPs have a role in informing patients when their health condition could be treated by a pharmacist instead of a GP. This helps to prevent unnecessary GP visits, provide a better patient experience and encourage patient behaviour change.

VITAL ROLE

Working closely with independent pharmacies across the UK, it is inspiring to see how deeply each and every team cares about serving their local community. The vital role community pharmacy can play is clear: providing a better patient experience and improving health outcomes by improving access. At the heart of our community, we should strive towards making pharmacy the first point of contact within our health system. Dr Zubair Ahmed is Chief Executive Officer of Medicspot. Go to www.medicspot.co.uk

At the heart of our community, we should strive towards making pharmacy the first point of contact within our health system

M AG A ZI N E | J U N E 2019 | 35

P f AWA R D S

A bright future Shannon Travers won the Best Newcomer Award at the Pf Awards 2019. Here she responds to her win, shares insights into her career and explains why we should listen to our parents, sometimes.

C

ongratulations on your Pf Awards 2019 win. How did you feel when your name was called out? I was in total shock when my name was called out at the Pf Awards. While I felt the Pf Awards Assessment Day had gone well and I gave a good account of myself, you never know how others have performed and your inside voice is always saying ‘it won’t be you’. You are always aware that the calibre of entrants to the Pf Awards is so high and you know you have to give it your best shot and be as prepared as you can be, but you have no indication from the judges as to how you have performed which is a little daunting.

One of my GSK colleagues had actually entered and won this Pf Award last year and I was fascinated by her journey. It sounded so exciting and I was totally invested from that point on. The fact that she went on to win the

Pf Award made me think it was achievable and I feel very much that you have to be in it to win it, so why not give it a shot? Both CHASE and GSK have been fantastic in terms of support and both were delighted to see me picking up the Best Newcomer Pf Award.

I hope I have done them both proud.

What does winning the Pf Award mean to you? Winning the Pf Award gave me some added validation that I was performing well. Performance is sometimes difficult to measure in this industry, so I felt incredibly honoured that the judges felt the work I had put in over the last year merited the Pf Award.

I try to always work with the patient as my main focus and to always do what is right by them. I was over the moon to have this recognised on such a public stage.

Tell me about your career so far. My degree is actually in Law; but following on from that I have been involved in many exciting

industries, from cars, through to running my own business with a product I created from scratch. This means I have joined this industry from a varied background with, I would like to think, a range of skills, many of which have been put to the test already.

You’re on contract to GSK, what do you enjoy best about your role? I work with GSK as a Sales Representative selling an asthma medicine to primary care customers in Glasgow. My favourite part of my job is, without doubt, the patient stories. I am incredibly passionate about working with my healthcare professionals for their patients. Nothing pleases me more than meeting a nurse who is eager to tell me how our medicine has changed their patient’s life. It’s that fantastic feeling of ‘I did something there; I really made a difference’

We've got a fantastic range of Sales, Marketing & Nursing roles across our Pharmaceutical & Healthcare clients.

Contact our highly experienced recruitment team today. chasepeople.com connect@chasepeople.com 3 6 | P H A R M A FI EL D.CO.U K

21 YEARS OF NURTURING 'CHASERS'

and that is what I strive for each day that I am at work. I’m consistently trying to uncover better ways to reach this outcome and to get the best medicine to patients.

What made you choose pharmaceuticals as an industry? My mum has worked in the industry for a number of years and has often said she thought this would be a job I would really enjoy. As a sulky teenager, and a moody 20-something, I was going to do anything other than what my mum suggested. However, as I grew up, I took her advice and looked into the industry and actually felt this was something I could really enjoy. A new, fresh challenge with the ability to help real people. I hate to say it (and she will love this) but sometimes, we should listen to our parents!

Where would you like your career to go?

I definitely see my future in the pharmaceutical industry, but for now, I want to focus on being the best at the role I am in currently; that is always my immediate goal. I want to excel at what I do before looking for the next opportunity. One day, I would love to work more closely with patients, although how that might manifest itself I am not sure.

Nothing pleases me more than meeting a nurse who is eager to tell me how our medicine has changed their patient’s life

INTERVIEW BY Emma Morriss

Would you recommend entering the Pf Awards? Firstly, I would just like to say thank you to all involved in the Pf Awards for making me feel so welcome. To the judges for making the whole Pf Awards Assessment Day (almost) enjoyable and to both GSK and CHASE for their ongoing support. I would whole-heartedly recommend, to anyone considering entering the Pf Awards 2020, do it! You might just surprise yourself. Shannon Travers from CHASE is on contract to GSK. She won the Best Newcomer Pf Award 2019 which was sponsored by CHASE. For Shannon’s Winner’s Interview go to www.pfawards.co.uk

We specialise in Pharmaceutical and Healthcare careers.

Please get in touch to find out what we can do for you. chasepeople.com connect@chasepeople.com

M AG A ZI N E | J U N E 2019 | 37

I

TIP OF THE ICEBERG

work across operations, strategy, supply chain and environmental health and safety compliance. I’ve been in the industry for over 30 years in operations and commercial. I’m a chemist by background but an operations person at heart. I’ve been with Accord for four and a half years. We are one of the fastest growing Indian companies and have the ambition to be a top five pharmaceutical company. However, we’re clear that if we put our patients and customers first then that will enable us to become top five.

Was industry prepared for FMD? FMD is the biggest European, IT-system platform-led project. It was always going to be incredibly difficult for everyone in the EU to come together on time. There were a number of phases to be initiated for a manufacturer as well as the marketing authorisation holder for each country involved.

The first activity was purchasing equipment; Intas/Accord purchased some 70 new pieces of equipment across its operations costing millions. This stage was ‘fairly simple’ though it is challenging

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to integrate new equipment into an existing production line whilst minimising disruption to supply.

The second activity was purchasing servers and proprietary systems, or some developed their own. This is the first time these integrated systems have been used in the EU, and they need to be integrated from manufacturing throughout the supply chain via a central European hub to end users. National systems also had to be built, providing integrated endto-end systems to carry manufacturing data through to pharmacists and wholesalers.

Obviously, the systems and processes play a huge part in FMD throughout the supply chain from manufacturing into national authorities; it’s been challenging. I believe there was an underestimation of the level of effort required to get it going. It has required the right people with the right training and knowledge in order to get everything prepared. There were a lot of regulations to be interpreted and put into place across the supply chain covering many countries, languages and national authorities.

The reality of the medical supply chain was more complicated than expected. There are many inter-transactional activities across many stakeholders ensuring medicines reach patients. It was paramount that the solution was not at the detriment of patient access to

medicines, whilst at the same time ensuring rigour in the supply of bona fide medicines.

It was a huge undertaking, but currently, the number of people uploading data to the EU system is very low, and that’s a challenge.

There are also a huge number of errors or false positives every day. There are taskforces working through the errors, but it’s a real challenge. However, it’s necessary in order to be able to identify the true counterfeit products.

Do you have any advice for those who may be struggling with FMD? If anyone is struggling with FMD, or new entrants to the market, the equipment aspect is fairly easy, but you must understand the systems and get them right.

In the early days, the master data is incredibly important. There’s a huge range of master data to bring together with lots of acronyms which need to work in the EU system.

I’d encourage people to get an expert in serialisation on board. Issues will arise in uploading data and if you don’t have the specific expertise and understanding of master data, it makes it a lot harder.

Also, if the master data is wrong the entire batch can be returned, meaning you need a good quality management system along with master data for the packs and the system.

These are critical. Set-up should be undertaken incrementally to make it easier to spot errors.

Q&A

TONY CORDREY IS VICE PRESIDENT OF EUROPEAN STRATEGIC OPERATIONS AT ACCORD HEALTHCARE. HAVING BEEN AT THE FOREFRONT OF THE FALSIFIED MEDICINES DIRECTIVE (FMD) ROLLOUT, HE BELIEVES WE’RE ONLY JUST SCRATCHING THE SURFACE OF WHAT 2D MATRIX CODING CAN ACHIEVE FOR INDUSTRY AND PATIENTS.

The 2D matrix is the first time that a product brings together the manufacturer, customer and authorities and it can go so much further, especially with the potential of the Internet of Things

INTERVIEW BY Emma Morriss

What role can technology play? We are only at the edge of what we are doing with technology; we’re following legislation to add the 2D matrix codes from manufacturing to pharmacist, but it doesn’t stop there. The 2D matrix code offers a world of opportunities and it’s currently just one-directional.

There’s so much more that can be done.

Given the investment by industry, there’s more to be gained than just verification.

What does the future hold for falsified medicines? We really need stability in the FMD system before moving forward.

However, once this has been achieved, the possibilities are incredible. We’ve had schools visit our operations and the first thing the children do when they see a 2D matrix is get out their phones to scan and read it. They see it as a gateway which opens up a wealth of opportunities.

It could link to the manufacturer’s website for product data sheets and patient information leaflets (PIL), patients could access pharmacovigilance information, report side effects, or have links to who to contact if they have concerns. There are so many possibilities. This could eventually save the need for printed PILs, saving paper and making the information accessible.

We have been here before with e-PILs

discussions but now industry and patient are in contact via digital technology.

This is the first opportunity for patients to take control of their medication. They could verify the product is legitimate and this can feed back into the system. The GP could then know that the patient has received their medication and has been informed of the product information and side effects. There’s even potential to remind patients to take their medication or when to go for repeat prescriptions, it can be fully integrated.

The 2D matrix is the first time that a product brings together the manufacturer, customer and authorities and it can go so much further, especially with the potential of the Internet of Things. As future generations come forward, this can only grow.

Currently, it’s just for counterfeiting, but as you can see, it has the potential to do so much more.

The only caveat I have is that technology is outpacing regulation and it will need to catch up with the potential that technology brings. Right now, it’s an opportunity and I look forward to the potential realities.

Go to www.accord-healthcare.co.uk

M AG A ZI N E | J U N E 2019 | 39

Growing pharma talent

Tom Woods is an ambitious young graduate.

Having started his career on a placement at MSD, he has held the roles of student business analyst, medical representative, business development associate and is now a business analyst for IQVIA. He shares his plans for going global and being at the forefront of industry developments.

INTERVIEW BY Emma Morriss

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hat attracted you to working in pharma?

When I was researching employment options at university, I found vision and mission statements of organisations fundamental when deciding where to work. Most pharmaceutical companies champion the idea of putting patients at the heart of the business to improve lives, which resonated strongly with me as a core ambition.

I wanted to become more involved with organisations that prioritise charitable medicine donation projects as well as develop my professional skillset along the way. I also found pharma an easy industry to relate to, because so many people have benefitted from medicines that scientists have discovered, developed and produced.

During my degree, I gained an appreciation of the effort and time experts devote to synthesising new drugs, but I was curious about how these medicines are commercialised and eventually get to the patients that need them.

P f TA L E N T

How did it help you get into pharma? I studied Chemistry with Management at the University of Bath, which allowed me to gain real world experience on a placement year. I worked as a Student Business Analyst at MSD. In this role, I learned from subject matter experts and other placement students about how the industry operates. I became increasingly knowledgeable about key therapeutic areas and the NHS environment by working across the MSD medicine portfolio. A few highlights include receiving an excellence award for creating a customer segmentation and targeting plan as well as cultivating collaboration with a large private healthcare provider. These projects were pivotal for starting my career in pharma and I feel very fortunate to have worked with a such a supportive mentor, manager and team during my first role in the industry.

What has been your path to your current role? After completing my placement year and degree, I decided to further my understanding of pharma by undertaking a customer-facing role. I joined Chiesi as a Medical Representative via CHASE, a contract sales organisation.

Daily discussions with healthcare professionals allowed me to gain a firsthand appreciation of the challenges faced by the NHS and experience how the pharma industry interacts with its customers.

I then explored a new position at Tanner Pharma, a pharmaceutical services company focused on providing solutions across the product lifecycle. Here, I honed my skills in business development by expanding a product sourcing network and helping to supply comparator products for clinical trials.

I recently joined IQVIA as a Business Analyst to support life sciences’ commercialisation. The team provides strategic recommendations to pharmaceutical clients of all sizes, making use of a wide range of data to help make every healthcare decision the right one.

What do you enjoy about working in pharma? The multifaceted nature of the industry means there is always the opportunity to learn from people from different backgrounds, different experience levels and different departments. I learned how to analyse trends to investigate the intricacies of pharmaceutical markets and I find this extremely interesting.

If a medicine is gaining market share, I like to examine the market dynamics and the associated drivers behind them in order to share best practice.

I take pride in providing high-quality insights and enjoy developing my skills in presenting, teamworking and critical thinking. It’s a genuinely great feeling to work alongside like-minded colleagues who share the same vision and provide strategic recommendations to the industry’s biggest players. Everyone I meet is passionate about enhancing the health of society and I think a great deal of this enthusiasm has rubbed off on me.

What were your impressions of the industry and have they changed? Before I joined, I was aware that pharmaceutical companies received some negative press for the work they do. In previous decades, regulations weren’t nearly as stringent as they are today, and I wanted to explore the extent to which the industry has progressed.

In my experience, there has been a decisive shift from a solely product-focused approach to a more patient-centric way of operating. For example, pharmaceutical companies now offer supplementary education as well as supporting resources to improve medicines adherence and compliance and foster better patient outcomes. In doing so, they have earned a more trustworthy reputation and have developed close working relationships with educational institutions, the Government and the NHS. I believe healthcare professionals increasingly recognise the importance of engagement with the pharmaceutical industry and its contribution to advancements in life sciences.

What advice would you give to other graduates? Many pharmaceutical companies, consultancies and market research agencies offer graduate schemes which are an excellent path into the industry because they often involve a series of rotations. Working across different departments allows the attainment of a broad perspective and opportunities arise to explore new areas of the business.

However, I took a different route, by first working as a medical representative, which is a great way to gain experience on the frontline of pharma and pass the ABPI exam.

I learned a huge amount professionally and personally, not to mention benefitting from

I believe healthcare professionals increasingly recognise the importance of engagement with the pharmaceutical industry and its contribution to advancements in life sciences

a company car and going on an international business trip. Graduates should read the Pf Graduate Guide and get in touch with an agency to find out more about available positions. There are many opportunities for people of the right calibre so find something they are passionate about, take every chance to network and be prepared to work hard.

What are your plans for the future? In the short term, I aim to deepen my expertise in driving maximum value for our customers, by providing them with commercial and scientific insights. In the longer term, I want to develop my managerial and leadership skills in addition to attending global healthcare conferences to expand my professional network. I also hope to gain experience in the USA and learn from people who have a culturally different perspective on healthcare provision.

Pharma is changing rapidly worldwide with personalised medicines, real world data and artificial intelligence becoming increasingly key to its success. I intend to embrace how these technological trends are disrupting conventional thinking and make an impact by helping to solve future healthcare challenges, allowing people to live longer, healthier and happier lives. Ultimately, I aim to stay at the forefront of the sector by guiding strategic priorities, striving for better patient outcomes and driving greater innovation across the industry. Go to www.IQVIA.com M AG A ZI N E | J U N E 2019 | 41

P f TA L E N T

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

Hannah Alderton

HEALTHCARE

John Wilkinson OBE John Wilkinson OBE, Director of Devices at the Medicines and Healthcare products Regulatory Agency, has announced his retirement.

HEALTHCARE

Stella Wooder

PHARMA

HEALTHCARE

Stuart Ashman

Tom Grinyer

SkinBioTherapeutics has appointed Stuart Ashman as an Executive Director. Ashman brings over two decades of commercial healthcare experience primarily in the medical devices industry, having held senior level positions in a range of large public and smaller private companies such as Onbone, Andover Healthcare and TI Group.

The British Medical Association has selected Tom Grinyer as its next Chief Executive.

Grinyer is currently the Chief Executive Office of the Royal College of Anaesthetists.

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

Stella Wooder has been brought in as a strategic adviser at Cambridge Healthcare Research.

Wooder brings to the role more than 25 years’ experience of healthcare and technology consulting. She currently Chairs the Board of Trustees at Team, which works with pharmaceutical and medical device companies to design and develop medical devices.

Dame Anna Dominiczak photograph courtesy of: University of Glasgow

HEALTHCARE

AGENCY

Dame Anna Dominiczak

Claire Scruton Claire Scruton joins Boyds as Senior Manager of CMC Regulatory Affairs. With 20 years’ experience in the pharmaceutical industry, Scruton will provide strategic regulatory CMC advice and operational support across a range of therapeutic areas and development stages for advanced therapy medicinal products, biologics and new chemical entities.

Professor Dame Anna Dominiczak has been appointed as MRC Health Innovation Champion, on secondment from the University of Glasgow where she is Vice Principal and Head of the College of Medical, Veterinary and Life Sciences. She has served extensively on national and international research committees and advisory boards, including the MRC’s Translational Research Group.

PHARMA

Richard Saynor Richard Saynor is the new Chief Executive of Sandoz. He has been with GSK for the past nine years where he is currently Senior Vice President Classic and Established Products, Commercial and Digital Platforms.

PHARMA

Dr. Mathew Minardi Sterling Pharma Solutions has appointed Dr. Mathew Minardi as its President US Operations. Dr. Minardi will head up Sterling’s North American operations. He brings with him a PhD in organic chemistry and a wealth of experience from previous roles at Accord Healthcare, Johnson and Johnson’s Noramco and Ampac Fine Chemicals.

HEALTHCARE PHARMA

Jerome

Dirk Pollet

Moreau

Mundipharma has appointed Jerome Moreau to Head of Market Access.

He joins Mundipharma from GSK, where he was Director, Global Market Access and Pricing.

He has over 25 years’ experience in biopharma, working in different sales and marketing roles, before he progressed into management and business development at pharmaceutical companies such as Johnson and Johnson.

AGENCY

Dr Germano Ferrari emotive has brought on Dr Germano Ferrari as Vice President, Advanced Therapies to oversee its new business unit. Germano is an expert in cell and gene therapies.

Enzyre, a developer of ambulant diagnostic technology for coagulation testing, has appointed Dirk Pollet as Chief Executive Officer.

Pollet has over 25 years’ experience in the diagnostics and biotechnology industries. He led Multiplicom NV, a European diagnostics company and served as Chief Business Officer of Cellectis SA. Pollet obtained his PhD degree in Biochemistry from the University of Antwerp.

PHARMA

Jean-Luc Lowinski Pierre Fabre Pharmaceuticals has appointed a new Chief Executive Officer, Jean-Luc Lowinski.

Lowinski is a veterinarian with an MBA from INSEAD. He has worked at Bayer and been Vice President of the Sanofi Group in Shanghai.

At Pierre Fabre, he oversees the development of pharmaceutical activities in oncology, prescription drugs and consumer healthcare.

M AG A ZI N E | J U N E 2019 | 43

CAREERS

HOW TO

GET INTO A HEALTHCARE AGENCY How do you get your foot in the door of a healthcare agency and where could it take you? WORDS BY Louise Lavelle

THE ROLES AVAILABLE

PERSONALITY TRAITS

Roles available across healthcare communications are generally split between client services: account management, and editorial: medical writing, editing and copywriting type roles.Increasingly, healthcare agencies also have an internal creative studio with designers, developers, art workers and digital specialities.

You’ll need to be: • warm and friendly • comfortable using your own initiative and contributing ideas • a strategic thinker • a problem solver • organised and methodical • a collaborative team player • a ‘roll your sleeves up and get stuck in’ type of person!

SALARY AND BENEFITS

WHAT IS A HEALTHCARE COMMUNICATIONS AGENCY?

H

ealthcare communications agencies support their clients with communicating information about their products. Their clients may include pharmaceutical companies, biopharma, medical devices and clinical research organisations.

The information communicated could relate to findings coming out from clinical trial data about new products, indications, efficacy, therapies and treatment options. The agency will work with their client to devise the strategy then develop the activities and materials most suitable for communicating their information effectively to their target audience.

Their overarching aim with communicating new clinical information is to change the behaviour (of healthcare professionals, physicians, patients) to improve patient outcomes.

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Entry level positions generally start around £22-25K and increase as the level of responsibility and diversity of knowledge increases. Benefits include bonus, healthcare and an opportunity to travel the world.

SKILLS AND EXPERIENCE

You’ll need a Bachelor’s degree ideally in a life science, and for editorial roles an MSc or PhD is preferred. A genuine passion for healthcare, engaging communication skills and a strong team ethos will impress potential employers.

HOW TO STAND OUT

If you can demonstrate anything over and above sound academic achievements – such as awards (academic, professional, personal), publications, presentations, attendance at conferences, work experience and relevant hobbies such as scientific/health blog writing – then you’ll be head and shoulders above the other candidates.

THE CAREER PATH

I see people moving within healthcare communications, from medical communications to advertising or PR, or from agency to in-house roles within pharmaceutical or a clinical research organisation. They can also transfer into roles in nutrition, consumer health or charities. There are plenty of opportunities available for someone in healthcare communications to develop professionally – the world is their oyster! Louise Lavelle is Team Lead of Healthcare Communications, Carrot Pharma Recruitment. Go to carrotpharma.co.uk

A genuine passion for healthcare, engaging communication skills and a strong team ethos will impress

MEDICAL EDUCATION EXPERTS

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