Pf Yearbook in a PDF format

Transcription

D I G I T A L
Use Zenopa to progress your career
We will guide you through every stage
We have two decades of experience placing sales, marketing and
executive personnel in the Heathcare Supplier Industries
Zenopa will always contact you before sending you forward for
a job, and we will help you prepare your CV accordingly
Our client relationships are built on years of service,
it’s in our interest to find you a job you will excel in
Before every assessment we will find out the format and
interview style of your assessor, and ensure you are ready
Think of where you want your career to go and call one of our consultants
Pharmaceutical Sales
Medical Communications
Pharmaceutical Executive
Testimonial
"I just wanted to express my thanks and gratitude for the really good service Zenopa has provided since my CV was forwarded. The process has been very
slick, you have always been amenable and knowledgeable about every process along each stage of interviewing, and that has made this career move that
much easier! The medical team have always been helpful and I would recommend Zenopa to all colleagues and acquaintances who are in the health care and
medical job market.”
Sam - Theatre Sales Specialist
Pharmaceutical Field
Editor Chris Ross
[email protected]
Assistant Editor Iain Bate
INTRODUCTION FROM THE EDITOR
[email protected]
Web Editor Diana Spencer
[email protected]
Designer Stephen Fisher
[email protected]
Sales Manager Jagdeep Oubhie
[email protected]
Finance Manager Sandra Workman
[email protected]
Administrator Lisa Maylin
[email protected] General Manager Heidi Sharland
[email protected]
Pf Awards Melanie Hamer
[email protected]
Publisher Dr Philip Brown
NHS ADVISORY BOARD
Omar Ali Surrey & Sussex NHS Trust
Paul Denny General Practice
Michael Sobanja NHS Alliance
INDUSTRY ADVISORY BOARD
Anne Chandler Vybrant Organisation
Niall Barry GEM Resourcing
Kristin Darlison IHS
Susan Glenn The Portland Partnership
Steven Passmore Teva UK
Lucy O’Neill STAR Medical
Mike Stowe SpePharm UK
Colin Watson Ashfield In2Focus
READERSHIP ADVISORY BOARD
Brian Bambrick-Sattar Chiesi
Rachel Dixon Eli Lilly & Co
Kim Hollis Pfizer
Shazad Khilji Schering Plough
Neeru Lorimer Merck Serono
Trisha McGarry Eli Lilly
Adrian McIlwrath Eli Lilly
Rosie Sheppard Pfizer
Sue Thomson Allergan
Gareth Williams Janssen-Cilag
IMPORTANT NOTICE
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.
Health Sector Publishing Ltd 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 (Health
Sector Publishing Ltd) 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
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No copying, distribution, adaptation, extraction,
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express permission of the Publisher and the copyright
owner (if other than the Publisher).
The information contained in this magazine and/or
any accompanying brochure is intended for sales and
marketing professionals within the healthcare industry,
and not the medical profession or the general public.
Pharmaceutical Field is published monthly.
For subscription details,
telephone 0121 633 0044
or fax 0121 633 0055.
2010: a year
of change?
Welcome to the 2010 Pf Digital Yearbook
– Health Sector Publishing’s first step into
the world of digital publishing, providing
our loyal audience of UK-based medical
sales professionals with a new and exciting
way to access market intelligence. The
Yearbook, available for viewing in pageturning PDF format on your laptop or as
an ‘eBook’ on iPad or equivalent, looks
back at the developments that shaped
the pharmaceutical industry in 2010,
the repercussions of which will be felt
throughout 2011 and beyond.
It would be easy to define 2010 as a year of
change for the pharmaceutical sector, but,
in truth, the industry – and the customerbase it serves – rarely stands still. Certainly
the selling environment for UK medical
sales professionals continues to evolve at a
rapid pace. Following years of steady (yet
seemingly relentless) health reforms, 2010
began with an almost eerie silence in terms
of NHS policy. It would prove to be the
calm before the storm. The May General
Election, which had driven the slowdown
in policy development, was followed by
the unveiling of what have been described
as the most radical set of reforms to hit the
NHS since its inception.
The White Paper for health in July 2010
laid out a blueprint for wholesale change
to the way healthcare will be delivered in
the UK. The Health and Social Care Bill,
which was presented to Parliament in
January 2011, formalises the aspirations
of the White Paper following a series of
consultations and will, it seems, face some
formidable opposition as it works its way
towards legislation.
For the UK pharmaceutical industry, which
has spent the past decade responding to
the evolution of New Labour’s 2000 NHS
Plan, the Health and Social Care Bill will
once again dictate a shift in customer-base.
The onset of GP Commissioning will
give budgetary power back to a familiar
customer-group, but the imperatives of
demonstrating both clinical and costeffectiveness mean that the rules of
engagement with GPs will be very different.
The industry has, for the past few years,
made a serious attempt to redesign its
sales and marketing model. For sales
professionals this has meant a dramatic
reduction in the size of the field-force
and, for those that have remained,
an evolution towards Key Account
Management. Alongside this, the clamour
for NHS/industry partnership, with sales
professionals tipped to be facilitators in the
process, has reached fever pitch – not least
because the demands of the QIPP agenda
has meant that NHS professionals are now
looking to industry for a different kind of
support.
The mantra from within has been that
the new and emerging role of the ‘rep’
dictates new skill-sets. But the allegation
from outside is that many Key Account
Managers are simply old-school reps with a
different job title. In a year of change, did
anything really change at all?
The 2010 Pf Digital Yearbook charts the
progress of the industry and, with links
back to additional features online at
pharmafield.co.uk, provides clear evidence
of the narrative outlined above: the political
reform, the ensuing uncertainty, the
industry’s operational response, and the
implications for the future.
In truth, 2010 was not so much a year of
change, it merely paved the way for one:
2011. In twelve months’ time, things really
will look different.
Chris Ross
Editor
JANUARY 2010
DH moves towards generic
substitution
The DH has promoted the use of
generic medicines in primary care
as part of proposals that it is hoped
will bring about long-term savings
for the NHS.
The proposals are now open to
a 12-week consultation. The ABPI
has welcomed the opportunity for
all stakeholders to express their
views, as well as the emphasis
given to patient safety in the DH
report.
The gateway to a commercial career in pharma
Is the NHS facing
Armageddon? p18
Becoming a
mastermind p20
January 2010
Management is
child’s play p26
DH moves towards
generic substitution
The DH has promoted the use of
generic medicines in primary care as
part of proposals that it is hoped will
bring about long-term savings for the
NHS.
The proposals are now open to a
12-week consultation. The ABPI has
welcomed the opportunity for all
stakeholders to express their views, as
well as the emphasis given to patient
safety in the DH report.
Various options for replacing
branded medicines with generics were
outlined, including a scheme whereby
a list of products are exempt from
substitution or where only certain
products can be replaced with a generic
version.
Under these options, health
professionals would be able to stipulate
on a prescription form where they do
not think it appropriate for medicines
to be substituted. Patients would
also continue to receive a specific
manufacturer’s product where their
treating clinician judges that this is
necessary to meet clinical need.
Pharmacists will be able to dispense
generic medicines instead of branded
products unless otherwise stated on the
prescription form.
The ABPI has responded that patient
safety should prevail and prescribers
should retain the right to prescribe a
particular branded generic. During
PFJAN10 - NEWS.indd 1
PPRS discussions, the ABPI argued
that certain groups of products should
be exempt from substitution based
on patient welfare and international
best practice, including modified
or sustained release preparations,
medicines with a narrow therapeutic
index, vaccines, biosimilars, devices
and routes of administration, and
controlled drugs.
The publication of the proposals
coincided with an independent piece of
market research, which indicated that
83% of Europeans believe generics are
as effective as the original product.
Health Minister Mike O’Brien
said: “We want to make sure that
patients and taxpayers are getting
the best medicines at the best price.
Where clinically appropriate, it is
Mike O’Brien
only sensible to allow more expensive
branded products to be substituted
with the same generic medicines, which
are just as effective as the branded
version.
“Patient safety is always our top
priority. (Continued on p2)
NICE reverses Yondelis decision
A new treatment which could extend
the lives of a specific group of cancer
patients will be available on the NHS
following a U-turn by NICE.
Final draft guidance has
recommended trabectedin (Yondelis)
as a treatment for certain patients with
advanced soft tissue sarcoma.
NICE reversed its original decision
not to recommend the drug after the
manufacturer, PharmaMar, agreed
to meet the costs of trabectedin if it
is needed beyond the fifth cycle of
treatment. The independent appraisal
committee also applied NICE’s criteria
for evaluating life-extending end of life
treatments.
The draft guidance is now with
consultees who have the opportunity
to appeal against the proposed
recommendation. Final guidance will
be published next year.
Dr Carole Longson, Health
Technology Evaluation Centre Director
at NICE, said: “We are delighted the
Independent Appraisal Committee has
been able to recommend trabectedin
in its draft guidance. It has certainly
not been an easy decision to make; soft
tissue sarcoma is a rare cancer and the
evidence was limited.
“However, treatment options for this
type of cancer are limited and in the
last 20 years there have been no major
developments to treat the advanced
stages of this disease. Being able to
recommend trabectedin for use on the
NHS represents a step forward in the
care of this group of patients who may
have very few treatment options left.”
NICE recommends the use of
trabectedin as a treatment for people
with advanced soft tissue sarcoma if
treatment with anthracyclines and
ifosfamide has failed, or if they are
intolerant of or have contraindications
for treatment with anthracyclines and
ifosfamide. Research shows the drug
can extend life by at least three months
more than other treatments currently
available on the NHS.
NHS in
England ‘more
efficient’
The UK has dropped to the bottom of
the official league table comparing the
prices of medicines across Europe, a
Government report has revealed.
For the first time, the UK lags
behind Austria, Belgium, Finland,
France, Germany, Ireland, Italy,
Netherlands, Spain and Sweden.
The NHS in England is more
efficient than elsewhere in the UK,
a new study has revealed.
A unique analysis of the
performance of the NHS across the
four countries of the UK has found
striking differences in performance,
funding and staff levels.
NICE decision NICE rejects
‘another step dronedarone
backwards’ for
To read the full
story, click on
the headline
Saflutan
approved in
Scotland
A new treatment which could extend
the lives of a specific group of cancer
patients will be available on the NHS
following a U-turn by NICE.
Final draft guidance has
recommended Yondelis (trabectedin)
as a treatment for certain patients
with advanced soft tissue sarcoma.
The SMC has accepted Saflutan
(tafluprost) for the treatment of
glaucoma, the first preservativefree ophthalmic prostaglandin
to be recommended for use in
Scotland.
Saflutan is recommended for the
reduction of elevated intraocular
pressure (IOP) in open angle
glaucoma and ocular hypertension
– as monotherapy in patients who
would benefit from preservativefree eye-drops or are insufficiently
responsive or intolerant to the
first-line therapy, or as adjunctive
therapy to beta blockers.
21/01/2010 16:41
Prices of
medicines hits
all-time low
The National Institute for Health and
Clinical Excellence (NICE) has decided
against RoActemra (tocilizumab) for
patients with rheumatoid arthritis (RA)
for the second time.
The Institute has issued new
preliminary guidance which
recommends that RoActemra is not
used in patients who do not respond
to DMARDs (disease modifying
anti-rheumatic drugs), and has issued
a ‘minded not to recommend’ decision
for RoActemra’s use in patients who
cannot tolerate anti-TNF treatments.
NICE reverses
Yondelis
decision
NICE has issued draft guidance
advising against NHS funding for
Multaq (dronedarone) to treat atrial
fibrillation.
The evidence provided to the
independent appraisal committee
indicates that dronedarone is less
effective and costs considerably
more than existing treatments for
controlling atrial fibrillation.
Industry and
NHS invest in
innovation
GSK is to join other private sector
companies in partnering with the NHS
and higher education bodies to provide
health education and training.
The new Health Innovation and
Education Clusters (HIECs) are crosssector partnerships between NHS
organisations, higher education and
private sector companies.
SMC decision
‘encouraging
news’ for CLL
Scotland has become the first
country in the UK to make
MabThera (rituximab) available
to all patients with the most
common form of leukaemia.
The Scottish Medicines
Consortium (SMC) has
extended its recommendation
on the use of MabThera to
include people with relapsed
and difficult-to-treat (refractory)
chronic lymphocytic leukaemia
(CLL) in combination with any
suitable chemotherapy.
NICE ‘unable’ to recommend
Alimta
NICE has revealed that, due to
data uncertainties, it is unable to
recommend Alimta (pemetrexed)
for the maintenance treatment of
non-small-cell lung cancer.
The draft guidance has been
issued for consultation and the
manufacturer, Eli Lilly, now has
an opportunity to consider and
respond to comments made
by the independent Appraisal
Committee.
Pharmaceutical Field YEARBOOK 2010
Shape our
success
in 2011
At Ashfield In2Focus, we rely on the drive
and dedication of talented people to help
deliver exceptional results to our clients.
As market leaders, our experience in
building specialist secondary care, primary
care and nurse teams is unparalleled.
Our continued growth means we can
offer unrivalled opportunities to develop
your career.
Great people are the key to our success.
That’s why we’re always looking for
outstanding individuals to take us further.
If you’re passionate, ambitious
and looking to be part of our 2011
success story, visit our website or
call us on 01530 562405.
www.ashfieldin2focuscareers.com
Ref: PF/J2011
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JANUARY 2010
Tories promise Sir Liam
a decentralised Donaldson
health service to retire
The Conservative Party has pledged
to scrap NHS process targets, open
up the NHS further to independent
sector providers, and enable patients
to choose their own providers at all
levels of healthcare.
The Conservative ‘Reform Plan
for the NHS’, published as the
first chapter of the party’s Draft
Manifesto 2010, places emphasis on
decentralisation. It consolidates a
number of policy statements made
in late 2009 – and echoes a number
of Labour commitments, including
the conversion of all hospital trusts to
Foundation Trusts.
England’s Chief Medical Officer,
Sir Liam Donaldson, has decided
to step down in May 2010 after 12
years of service.
Appointed in 1998, Sir Liam is
the longest-serving Chief Medical
Officer of modern times.
M&A has contributed 63% of ‘big
pharma’ sales growth over 1995–2014,
recent analysis by Datamonitor has
revealed.
The industry analysts also predict that
large-scale M&A activity will remain an
integral strategy of big pharma and will
continue to contribute nearly two-thirds of
peer set sales growth in the year up to 2014.
EC approves
intravenous
PAH therapy
Sir Liam Donaldson
Six new Business
Ambassadors for CHMP update
UK life sciences The December meeting of the CHMP
Prime Minister Gordon Brown
has appointed six new Business
Ambassadors – business and
academic leaders chosen to support
the Government in promoting the
UK’s excellence internationally.
The new Business Ambassadors
include Chris Brinsmead,
Chairman of AstraZeneca UK,
and Lord Ara Darzi, Professor
at Imperial College and former
Health Minister, representing the
UK life sciences industry.
saw the recommendation of marketing
authorisations for six new drugs and a
review of swine flu vaccines.
The Committee reviewed further
data on the pandemic flu vaccines
Celvapan, Focetria and Pandemrix
and the antiviral Tamiflu. In the EU
at least 26 million people have been
vaccinated so far, and worldwide 13
million patients have taken Tamiflu
from 1 May 2009 to 31 October 2009.
The European Medicines Agency
has reaffirmed the positive balance of
benefits and risks in the context of the
current H1N1 pandemic.
Patent box
to boost UK
investment
Alcon
shareholders
challenge
The ABPI has welcomed the proposal
for a ‘patent box’ outlined by Chancellor
Alastair Darling in his Pre-Budget Report.
The patent box is being introduced
to encourage research and development
within the UK from the pharmaceutical
and biotech industries. In his speech, Mr
Darling said he would bring in a 10%
corporation tax rate on income that stems
from patents in the UK.
Alcon’s minority shareholders have
filed a class action against Novartis for
offering two groups of Alcon shareholders
different prices for the same stock.
Law firm Labaton Sucharow LLP
is advising the shareholders on the
prevention of the $39 billion merger
proposed by Novartis in which, it argues,
Alcon’s minority public shareholders will
be “squeezed out at an unfair price”.
M&A strategy
to continue
Revatio (sildenafil) has become the
first pulmonary arterial hypertension
(PAH) treatment in its class to be
approved as an intravenous (IV)
formulation, allowing access to patients
who are unable to use oral therapy.
The European Commission has
approved Pfizer’s treatment in an IV
formulation for patients with PAH
who are prescribed oral Revatio but are
temporarily unable to take it.
NICE
launches new
guide
NICE has launched How to use NICE
guidance to commission high quality
services, a guide that explains how NICE
guidance supports the commissioning of
high quality services and describes how
the guidance can be used throughout the
commissioning cycle.
The guide is aimed at everyone
involved in commissioning health and
social care services.
Follow Pf on
Twitter
@PharmaField
Clough
secures new
ABPI role
Alison Clough has been promoted to
Commercial and Communications
Director at the ABPI.
Alison will be responsible for both
the commercial and communications
functions at the ABPI, and for coordinating the work of the ABPI’s
four work streams around Value,
Innovation, Trust and Access (VITA).
Alison Clough
Pharma sends
relief to Haiti
Pharmaceutical companies are leading
the way in providing support and
donations of supplies to aid workers
and victims of the Haiti earthquake.
Major companies, including Pfizer,
GSK, AstraZeneca and Novartis, have
responded to the call for aid following
the tragic events in early January.
Donations, including the provision
of pharmaceuticals and nutritional
products, have also been made by
Merck Serono, BMS, Eisai, Eli Lilly,
Amgen and Abbott.
AZ enters into
Novexel
AstraZeneca has entered into an
agreement to purchase Novexel, a
private infection research company
based in France, for $350 million.
The company is also to collaborate
with Forest Laboratories on the
future co-development of two
late-stage antibiotic development
programmes that utilise Novexel’s novel
investigational beta-lactamase inhibitor.
CUSTOMER FOCUS
Is the NHS facing
Is the NHS facing Armageddon from 2011?
ARMAGEDDON
from 2011?
Mike Sobanja, Chief Executive, NHS Alliance and Andy Etheridge, Commercial Director,
Cegedim Dendrite, assess the outlook for 2010 and beyond.
Pharmaceutical Field January 2010
P
olitical uncertainty and the ongoing impact of the swine flu
pandemic are major concerns
for NHS senior managers. But it is the
possible financial meltdown that is the
number one issue to consider in 2010.
With projected deficits for this
year alone already coming in at £50
million from individual Trusts, the big
question is just how senior managers
plan to manage the financial pressures.
Will they revert to the 1980s style
of slash and burn, drastically cutting
down the number of outpatient
appointments, removing beds and
reducing surgery? Or will a positive
response to the Quality, Innovation,
Productivity and Prevention (QIPP)
agenda be enough to increase
efficiency and achieve more effective
management of resources?
Crisis point
Senior managers are warning that
the NHS faces the greatest financial
pressure since its inception. Indeed,
a study by the King’s Fund and the
Institute for Fiscal Studies forecasts a
funding gap of between £20bn and
£40bn by 2017, if funding for the
NHS receives no increase or gets a
real term freeze which only keeps pace
with inflation.
NHS Trusts have been asked by
the Secretary of State not to second
guess the Government on financial
projections. With the next round
of funding plans due for 2011,
organisations are currently planning
on the basis of 0.7% gain – which is
estimated by the Institute of Fiscal
Studies, as a decline of 2.3% in real
terms.
It is little surprise that, working
on this basis, a number of Trusts
are already predicting multi-million
pound deficits. The issue is just how
are these organisations planning to
address the shortfall? It is clear that
after years of investment, the NHS
must now retrench alongside
other public services. But
the response and
strategies put
in place
this
year will have long term implications
on the level and quality of care.
Jobs and services cut this year to
meet budgets are unlikely to be
reintroduced in subsequent years until
financial pressures ease – creating very
real implications for the quality and
timeliness of patient care. Yet given
the scenario planning released by some
PCTs, it would appear that drastic cuts
are under consideration, including
a massive reduction in outpatient
appointments. The potential outcome
of such strategies has been termed by
some an NHS ‘Armageddon’.
QIPP agenda
But it is questionable whether this
‘slash and burn’ approach to cost
reduction can be delivered in today’s
NHS. The world has moved on
significantly since the early 1980s,
with a strong focus on quality targets,
a reduction in waiting lists and the
introduction of patient rights under
the NHS constitution. It is unlikely
that the electorate would stand for a
wholesale reduction in the quality and
depth of NHS services – therefore an
alternative approach is required.
Executive David Nicholson wrote of
QIPP: “..meeting the challenges is
central to the role of every NHS leader
and every NHS board. In short this is
your day job.”
CEs are now beginning to review
ongoing strategy, and budgets,
with quality, efficiency, improved
productivity and prevention in mind.
And this will affect every aspect of
service delivery and budgetary spend.
For example, prescribing decisions
will now take into account additional
factors such as long-term effectiveness
and outcomes, including the ability of
a drug to reduce hospital admissions
and improve day-to-day management
of a condition in the community, and
to reduce the cost to care per patient.
Political change
Of course, the timing of this financial
crisis is unfortunate: in the run up
to the general election the political
uncertainty is certainly not helping
the planning process or enabling CEs
to embark on innovative strategies
with confidence. Furthermore,
whilst many in the NHS have been
working towards the need to meet a
NHS Chief Executive David Nicholson
wrote of QIPP: “..meeting the
challenges is central to the role of
every NHS leader and every NHS
board. In short this is your day job”
Indeed, the belief behind the
Quality, Innovation, Prevention and
Productivity (QIPP) agenda is that the
NHS can only survive in this financial
climate, with greater demands being
placed on it every day, if it innovates
and improves. And the Government
is putting strong faith in this strategy:
with central funding and leadership in
place and a clear planning focus. There
is also an expectation of personal
responsibility to adhere to the
QIPP recommendations. In
a letter to the CEOs of
each PCT, NHS Chief
Conservative agenda, the latest polls
are suggesting the possibility of a hung
parliament, which would bring Liberal
Democrat NHS policies into play for
the first time, and the prospect of an
unpredictable mixed bag of policy.
Certainly the NHS looks set for
further change – with a Conservative
Government planning to ring fence
the public health budget, create an
independent NHS board and make
practice-based commissioning budgets
real. And should the Conservative
Party come to power, it will bring
further divergence between national
strategy, with the Scottish and Welsh
health policies following a very
different political agenda that will
continue to avoid any form of market
exposure.
But whichever party comes to power
in 2010, the demands facing the
NHS will be the same: costs must be
reduced and there will be an increasing
focus on improving efficiency and
productivity.
Conclusion
By this time next year, the implications
of this financial crisis on the NHS will
be clear. A new government could be
in place and PCTs will have completed
the 2011 round of budget planning.
It is also likely that a programme for
consolidating PCTs will be underway,
with an expectation that numbers will
be reduced by up to one third over the
next few years.
The implications for prescribing
practices will also have become
clearer, as organisations increasingly
combine the recommendations of
QIPP with the expected renewed drive
for the adoption of generics wherever
possible. And the growing differences
across England, Wales, Scotland and
Northern Ireland, especially in key
strategies such as commissioning, will
be even more apparent.
2010 looks set to be a year of
further, very significant change;
with PCTs juggling extremely tough
financial targets with the need to
drive up efficiency and innovation.
Will it be Armageddon? Too soon
to say. But there is no doubt that
it is during this year that the target
will come sharply into focus: the
pharmaceutical industry will know
exactly what it has got to hit if it is
to avoid simply being a victim of the
financial squeeze.
Andy Etheridge is Commercial
Director for Direct Marketing
at Cegedim Dendrite. Cegedim
Dendrite provides value added
information, CRM and Marketing
solutions to the pharmaceutical
industry. Mike Sobanja is Chief
Executive of the NHS Alliance the only organisation that brings
together PCTs with GP practices,
clinicians with managers and board
members, and NHS primary care
with its patients.
Becoming a Mastermind
Your specialist subject is…?
Pharmaceutical sales professionals need to brush up on their specialist and general knowledge if they
are to make the most of the opportunities provided by world class commissioning. Andy Lee puts the
field force in the big black chair. Do you have the answers?
I
f, as a pharmaceutical sales
professional, you have only one
new year’s resolution as you
begin 2010, it should be to become a
Mastermind. Your specialist subject?
Well, that needs to be a composite of
your disease area, your product (and
the services it can sit within), your
customers and your marketplace.
Knowledge is power – the key
question is: do you have enough
knowledge to ensure your product is a
success in 2010? If you’re planning to
rely on the traditional, sequential sales
approach that has previously served
the industry so well, the answer will
undoubtedly be ‘no’.
Aside from the industry’s need to
improve efficiencies within the field
force in an endeavour to contain
costs, another major driver for a
change in sales methodology is the
continued emergence of a customergroup at the centre of a changing
NHS – the commissioning function.
Whilst this is not a new customer
for pharma, its role is becoming
increasingly more influential – and
the need to understand and engage
with it has become imperative. The
era of solely targeting clinicians is over
– the need to influence customers
responsible for implementing services
across the NHS is now paramount –
and that means commissioners. The
opportunity for pharma to support
the world class commissioning agenda
is real – but the stakes are high, not
only for the industry, but also for the
NHS.
The UK health service is facing a
funding gap of potentially gargantuan
proportions – NHS Chief Executive
David Nicholson says it could be as
high as £20 billion over the first three
years of the next spending round.
Nicholson is, of course, the driving
force behind the health service’s
QIPP agenda, which promises
a focus on Quality, Innovation,
Productivity and Prevention across
the NHS. The overriding challenge
for a health service driving for
quality is unequivocal: achieve
more, but spend less. Improving
patient care against a backdrop of
fiscal turbulence will hinge upon the
effective commissioning of services.
Commissioners have a huge role to
play.
Last autumn, Nicholson explained
how commissioning would play a
pivotal role in addressing the many
challenges facing the NHS. World
For medical sales professionals, success really
does depend on becoming a Mastermind.
You need to know your specialist subject
inside out, and also to demonstrate a
good general knowledge of your market
and your customers. The traditional sales
representative’s training has always begun
with clinical product knowledge.
class commissioning would, he said,
help identify and develop strategy
and put systems and processes in
place to deliver quality. But he
warned that achieving success would
require a redoubling of effort and
a change in mindset to move the
service forward. “This really is the
time when commissioning needs to
deliver,” he said. “Both commissioners
and commissioning now need to
make sure we can take forward these
great visions and strategies and make
them a reality for our patients and
communities.”
The scale of the challenge for
the NHS is colossal – but with it
comes an opportunity for pharma
to help deliver improvements and
transform services. Gary Belfield,
the DH’s Acting Director General
for Commissioning & System
Management Directorate, says that
WCC and PCTs need to ‘step up’
and be ‘brave and bold’ if they are
going transform healthcare. The
commissioning function therefore
needs to raise the bar to drive health
outcomes and improve patient
experiences. Commissioners need to
embrace and advance radical change
to succeed. They are grappling with
the challenge to be fit for purpose.
To support them, the pharmaceutical
industry must do exactly the same.
Specialist subject
So are you fit for purpose? Last
November, the first article in this twopart series provided a simple guide to
the commissioning function, showing
how the industry can engage with
these important customers and, in
the process, help meet the ambitions
of world class commissioning. The
article outlined the most likely
scenarios for interaction with
commissioners. But having identified
the doors on which you need to
knock, and when best to knock on
them, as sales professionals, what do
you do once you’ve been invited into
the room? How competent are you
and your organisation in developing
dialogue with these key customers?
And how do you move from simple
dialogue to real action? If you’re to
become a Mastermind in 2010, you’re
going to need to make the following
competencies part of your specialist
subject.
1
Sophistication
NHS commissioning is desperately
short of capacity and capability.
The commissioning community is
small and, at present, the number
of capable commissioners is low.
The ones that do exist are incredibly
over-burdened. So if you are going
to help the NHS, you will need to
be offering solutions that address
these deficiencies. Sales professionals
need to do their homework –
detailed preparation will put you in
pole position. But clinical product
knowledge will not be enough – you
need to be more sophisticated.
Ahead of your approach, you’ll need
to understand where your offerings
align with commissioners’ priorities
– whether from a single product or a
portfolio perspective. Which of the
common commissioning scenarios
is most appropriate for your brand?
Is it service redesign, or is it PBC?
Is it several of them? You need to
understand where you can make that
engagement, and make sure you can
get your messaging right so that when
you push on the door, it opens.
Being more sophisticated depends
as much on improving your
communications internally as it does
externally. The industry is beginning
to encourage a more integrated
approach to sales and marketing.
The two departments – which have
traditionally operated in ‘silos’ – are
now working more closely together.
This is vitally important. Marketing
messages must be built from a shared
understanding of all customer groups,
and tailored accordingly – and
as a company’s biggest customerfacing body, the sales force has a
significant role to play in identifying
and communicating customers’
needs. Between you, the solutions
you prepare need to demonstrate
how your product, or portfolio, can
support the commissioner’s challenges
of capacity and capability. What can
you do to support your product that
will help support them?
In fact, pharma companies are
well-placed to provide valuable
information for commissioners –
much of which will help address
their lack of capacity. Through their
meticulous research processes, drug
companies generate huge amounts
of disease expertise when developing
their products – this information can
easily become additional capacity
that can be offered to commissioners.
For example, where appropriate,
budget impact models or adaptable
service specifications that support the
redesign of a service will undoubtedly
provide value to a commissioner.
The industry can also help address
capability issues. This might be
the provision of additional skilled
human resource – such as a capable
project manager to drive through
a commissioning work stream.
Alternatively, pharma companies may
be able to provide a KOL who can
talk to non-clinical commissioners
about a specific disease area and what
the issues are for payers. In therapy
areas where commissioners have
prioritised a major service redesign,
such additional capability is of
real value. The DH has identified
increasing the engagement between
clinicians and commissioners as
a major priority in its objective
to develop more ‘informed’
commissioners. Pharma is wellpositioned to facilitate this. To do
so, sales and marketing professionals
must become more proactive,
more communicative and more
sophisticated in their methodologies.
2
Empowerment
Pharma is now adopting an
account management model –
deploying a reduced number of sales
professionals, but promising the
chosen few more responsibility and
greater accountability. The role of the
account manager is largely seen as
being a more specialist position with
a much broader customer-base that
includes influencers from across their
entire local health economies. As we
have seen, to succeed, dialogue needs
to be more sophisticated. But has
the model moved beyond rhetoric?
As an account manager, are you
empowered to be able to build on
the sophisticated discussions you are
having? You may be able to talk the
talk, does your brand team empower
you enough to walk the walk?
Lack of empowerment in the field
force is, sadly, not uncommon. But
to capitalise on the opportunity of
WCC, this cannot remain the case.
A sales professional who is only able
to talk about the product, but is not
allowed to discuss the wider disease
agenda, will not be able to develop
the kind of dialogue that will interest
commissioners. An empowered
field-based person will not only be
able to ask the right questions, but
will be able to act upon the answers
they are given. Too often, account
managers ask questions and gather
answers, only to exit the discussion
armed with a ‘wish list’ and fail
to return with a solution. This is
because too few of them are actually
empowered or understand what it is
that they can put forward. As a sales
professional, being passive is not
enough: it is your responsibility to
push for this empowerment.
The challenge for fieldbased personnel is to identify
commissioners’ capacity and
capability needs, and to enter into
a negotiation/discussion about the
level of help they may be able to
A sales professionals who is only able to talk
about product, but is not allowed to discuss
the wider disease agenda, will not be able to
develop the kind of dialogue that will interest
commissioners. An empowered field-based
person will not only be able to ask the right
questions, but will be able to act upon the
answers. It is your responsibility to push for
this empowerment.
provide. Identifying needs is about
framing the question in the right
way: why does the commissioner
feel the need to redesign the service?
Where is the current service falling
short? What level of care are current
patients are getting? Where are
the variations in care? Are there
particular groups of patients that are
missing out?
And if you are empowered enough
to ask the question, you need to be
similarly empowered to be able to
build on the answer. Negotiating the
solution is about knowing what can
be put on the table – in advance.
For example, if your account
manager gets into a negotiation
where the commissioner is revealing
that he needs a half dozen trained
data analysts, there is no harm in
responding that it’s not possible and
offering an alternative solution. The
industry should not be afraid to have
the discussion. But do you know
your terms of engagement?
Once again, preparation is key.
Ongoing communication between
sales and marketing departments
is essential to drive it. Marketers
need to have agreed the options
ahead of any customer engagement.
If together you can agree what
your areas of strength are, and the
limits of what you can do, as a sales
professional you should be able to
turn discussions around to areas
where you can really help – rather
than having wide-ranging discussions
about problems, creating long wishlists and then running scared.
The industry can provide
a number of solutions for
commissioners. These include:
•
•
•
•
•
•
•
•
disease expertise
project management
facilitation of clinical engagement
data – both clinical and patient
experience
patient education
access to KOLs
market development strategy
outcomes-based evidence.
All of these solutions are readily
available and can be shared. At
present, the channels to share them
aren’t being created in an optimal way.
Much of this boils down to a lack of
empowerment.
3
Matching local
agendas
where you need to match agendas. A
commissioner needs a good service
specification and a plan to implement
it – and, if you understand their
priorities and are operating in a
disease area that aligns with them,
you should be well-positioned to help.
Faced with a shortfall in both capacity
and capability, most commissioners
should be very open to partnering
with pharma companies that can help
design plans that fit their local needs
and, equally, can help deliver them.
This builds naturally from the
first two competencies. If you are
sophisticated in your approach and
understand how your product or
portfolio fits with what the NHS is
looking for, and you are empowered
to negotiate the solution you can
provide, your ability to match
agendas successfully will be crucial.
It lies at the very core of the account
management model.
4
Flexibility
Having matched agendas, to progress
further you will need adaptable
offerings. To do this, you’ll need
high quality generic templates,
processes and frameworks that can
be customised to suit individual
customers. Through dialogue
with a commissioner, your shared
objective should be to co-develop
a blueprint that will deliver the
capacity and capability required.
These will normally be developed
with marketing, and will be
heavily dependent upon customer
information garnered in the field.
Offerings could include:
Whether in sales or marketing, being
able to match your agenda with that
of the commissioner is imperative.
To succeed you will need a level of
understanding and a high degree of
influencing skills. If, in proposing a
solution that matches your agenda,
you can show how it helps provide
something that a commissioner is
looking for, your power to influence
will increase.
As identified in the first article, the
role of the commissioner is divided
into two basic areas: specification and
implementation. These are the areas
•
•
•
•
•
•
a best-practice patient pathway
generic service specifications
case studies, including clinical
models, examples of market
development and procurement
options
good data sets and access to data
that can be interrogated at a local
level
models for stakeholder
engagement
project management process
including frameworks
for communications and
mobilisation plans.
MARKET ACCESS
5
Matching the
national agenda
The national agenda is, perhaps,
the most important one to match
– and that is the drive for quality.
The industry needs to equip for
QIPP. Responsibility for driving
the QIPP agenda belongs to Jim
Easton, National Director of
Improvement and Efficiency, who
has pinpointed commissioning as
a central component in achieving
success. Describing commissioning
as ‘driving clinical change’,
Easton says its purpose includes
reshaping the pattern of demand
to focus more on upstream care
and prevention, and away from
the expensive ‘rescue end’ of care.
Commissioning, he says, includes
redesigning at scale, and at pace,
clinical pathways for chronic
disease management and for urgent
care in a way that will unlock the
experience of patients and unlock
cost and quality together.
For pharma, focusing on quality
care for patients is critical. If your
approach is built around delivering
that, it will be very difficult for
today’s NHS to argue against it. By
keeping the patient at the centre of
your plans, and at the heart of your
messages, your chances of success
increase dramatically.
The health service is changing,
and world class commissioning is
at the centre of that change. The
NHS is having to alter its mindset
and behave differently. The pharma
industry must follow suit. The era
of joint working between NHS
and industry is here. As Jim Easton
says, to solve its problems the
health service needs co-operation,
collaboration and people finding
ways of solving problems together.
“We need innovation on how
we deliver. We need the sort of
innovation which is innovating in
how you take great ideas and put
them on the ground in a way that’s
really going to make a difference.”
For medical sales professionals,
success really does depend on
becoming a Mastermind. You need
to know your specialist subject
inside out, and also to demonstrate
a good general knowledge of your
market and your customers. The
traditional sales representative’s
training has always begun with
clinical product knowledge. For
many, it largely ended there too.
In today’s marketplace, product
knowledge is only the beginning.
Success requires so much more.
The chances are, you’re probably
already half way there. So in true
Mastermind fashion, you’ve started,
now you must finish.
Andy Lee is Commissioning and
NHS Partnerships Director, WG
Consulting. Tel: 01494 470760 or
email: [email protected].
ow
N
e
liv
For a clearer picture of the
pharma job market, visit the
Pharmajobs website
Providing improved job search
capabilities and more ways
to secure your perfect
pharma sales position
than ever before!
www.pharmajobs.co.uk
FEBRUARY 2010
Pharma giants make further
job cuts
AstraZeneca and GSK have revealed
plans to cut thousands more jobs
as part of restructuring plans from
2010 onwards.
AZ has announced expected cuts
of 8,000 over the next five years,
in addition to the 12,600 positions
that have already been cut. GSK will
cut 4,000 more jobs from its global
workforce of 99,000.
The FISH!
school of
management
Pharma giants make
further job cuts
AstraZeneca and GSK have revealed
plans to cut thousands more jobs as
part of restructuring plans from 2010
onwards.
AZ has announced expected cuts
of 8,000 over the next five years, in
addition to the 12,600 positions that
have already been cut.
GSK will cut 4,000 more jobs from
its global workforce of 99,000.
Whereas AZ will be making general
cuts worldwide, GSK is making
reductions from its US and EU
operations in order to target emerging
David Brennan
markets.
Both companies have revealed that
sales and marketing departments will
be cut as part of the cost-saving efforts,
but neither has specified to what extent
the UK sales force will be affected.
In publishing its financial report
for 2009 and outlook for the next few
years, AZ predicted a difficult year
ahead for pharma. Despite reporting
a net profit increase of 23% for 2009,
the company admitted that the year’s
revenue was boosted by factors such as
the swine flu outbreak that are unlikely
to have a positive impact in 2010.
AZ CEO David Brennan,
however, remained positive: “In
2009 we delivered a strong financial
performance, exceeding the targets we
set at the beginning of the year,” he
said. “In addition, good progress was
made on the pipeline; we now have five
products awaiting regulatory approval,
and have added four significant late
stage development projects through our
externalisation efforts.
“Our plans for the next five years
confirm our commitment to researchbased, innovative biopharmaceuticals.
I believe successful execution of this
strategy will benefit patients and
generate the cash-flow necessary to
provide for the investment needs of the
business and shareholder returns.”
GSK has yet to release its financial
reports and details of the job cuts,
though analysts are optimistic about
the company’s pipeline, which contains
more than 30 products in advanced
development. The company also has
launches planned for its products
Menhibrix, a vaccine to combat
meningitis, and Benlysta, a treatment
for lupus.
US sales forces on the
chopping board (p8)
February 2010
Hard times
ahead for the
NHS
Aligning with
the QIPP
agenda
Collaboration
the key in
Pharma 3.0
Pharma companies are increasingly
looking for innovative ways to
collaborate with new players to improve
patient services, a new Ernst & Young
report has found.
Despite agreement among industry
executives that companies such as IT,
retail and telecommunications firms will
help reshape the healthcare marketplace,
most feel unprepared to address the
challenges these new creative alliances
will bring.
The Progressions, Pharma 3.0 report
identifies several industry trends driving
this collaborative working, including
health reform, health IT, comparative
effectiveness and the rising confidence in
consumer power.
These factors and others are prompting
pharmaceutical companies to broaden
their focus from simply producing
new medicines to delivering ‘healthy
outcomes’ – a shift that will be driven
through creative partnerships and the
adoption of new business models.
(Continued on p2)
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18/02/2010
Osteoporosis
guidance
stands
Duo not
recommended
by NICE
NICE’s original recommendations
on the prevention of osteoporotic
fractures remain unchanged, despite a
legal challenge to the process used to
produce the guidance.
Merck’s Fosamax (alendronate)
remains the recommended treatment
option for both primary and secondary
prevention of fractures.
NICE has updated its draft
guidance on the use of Bristol
Myers-Squibb’s dasatinib (Sprycel)
and Novartis’ nilotinib (Tasigna) for
chronic myeloid leukaemia.
Following a public consultation,
both NICE and the Appraisal
Committee have agreed to split the
appraisal of dasatinib and nilotinib
in this indication into two separate
appraisals.
Pfizer reveals Collaboration
R&D outlook the key in
Pharma 3.0
Pfizer has launched a portfolio of
generic medicines for its pharmacy
and dispensing customers in the UK.
The six products have been
introduced into Pfizer’s Established
Products Business Unit portfolio
of over 80 of patent medicines,
following agreements between Pfizer
and generic medicine manufacturers
Aurobindo Pharma Ltd and Claris
Lifesciences last year.
Pharma companies are increasingly
looking for innovative ways to
collaborate with new players to
improve patient services, a new Ernst
& Young report has found.
Despite agreement among industry
executives that companies such as
IT, retail and telecommunications
firms will help reshape the healthcare
marketplace, most feel unprepared
to address the challenges these new
creative alliances will bring.
EMA pledges to
improve access
to medicines
Steve Poulton
Sanofi vaccines
included in top 10
breakthroughs
Two of Sanofi Pasteur’s vaccines have
made it into Time magazine’s list
of the 10 most important medical
breakthroughs of 2009.
The firm’s HIV vaccine came
in second place. The magazine
highlighted that trials of its effectiveness
yielded “reasonable” results, with an
infection prevention rate of 31%.
(EMA) has pledged to improve access to
medicines in its new publication Road
Map to 2015.
The Agency has admitted that its
model for analysing the benefit/risk
ratio of products needs to be improved
and that it cannot continue to operate
in the same was as it has done for the
past 20 years.
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HAVE YOUR SAY
PF COMPANY PERCEPTION,
MOTIVATION & SATISFACTION
SURVEY 2011 - OUT JANUARY
Alliance buys
Cambridge Labs
Protelos
No NICE
decision for
Iressa
NICE has ruled that it is unable to
assess Iressa (gefitinib) in non-small-cell
lung cancer and has requested more
information from the manufacturer.
In draft guidance, NICE has asked
AstraZeneca to provide more data on the
effectiveness of its product as a treatment
for locally advanced or metastatic
non-small-cell lung cancer.
Speciality pharmaceutical company
Alliance Pharma has agreed a deal to
purchase Cambridge Laboratories
in the UK and Ireland for between
£14.3m and £16.4m.
Included in the acquisition are 18
prescription products across a range of
therapeutic areas, including: ImmuCyst, an immunotherapy for superficial
bladder cancer; gelclair, an oral gel
for the management of oral mucositis
caused by chemotherapy and radiotherapy; and procarbazine, a treatment
of Hodgkin’s Lymphoma as part of
chemotherapy treatment.
To read the full story,
click on the headline
Pioneering access scheme
recommendation
Cimzia has become the first RA
treatment to receive positive guidance
from NICE in more than two years
due to an innovative patient access
scheme.
Certolizumab pegol, or Cimzia, has
been recommended for approval for
the treatment of adults with severe
active RA, on the condition that the
patient access scheme is implemented
and the drug is prescribed in
accordance with NICE’s specifications.
Making people
healthier all over
the world –
it’s the most
rewarding work
you can do.
In this era of profound change we call the New Health, Quintiles is helping pharma companies
bring new medicines to patients faster. What role will you play?
Quintiles recruit talented individuals from the NHS and Pharma to become part of their
commercial teams in a wide range of roles and therapy areas including:
Oncology Hospital Specialists
Healthcare Development Managers
Medical Devices Representatives e.g. Orthopaedics; diabetes devices
Key Account Managers
Medical Sales Representatives – primary and secondary care
Sales Management
Find us on:
Dental Sales
Nurse Advisors and Nurse Managers
Quintiles* Voted No. 1 CSO for 9 consecutive years
Voted Best Places to work 2008, 2009 and 2010
Winner of the Pharmatimes Sales Recruiter of the Year 2008/2009 and 2010/2011.
Quintiles – the global pioneer in pharmaceutical services has worked with biopharma companies
in the development or commercialisation of the top 30 drugs and 9 of the top 10 products on the
market today. We have worked with over 300 pharma and biotech companies, covering 550
products in 150 therapy indications through our 23,000 employees in more than 50 countries.
To ﬁnd out more about Quintiles and how to become one of our talented and highly sought after
employees, who make a diﬀerence, visit www.quintiles.com or contact our Talent Management
Team on 01344 601550.
*Quintiles, formerly Innovex. Corporate
identity remains Quintiles.
Royce - Experience the Difference
Are you looking for a new challenge or a different role in 2011?
Do you want access to the best jobs in the sector; the highest chance
of success and first rate support?
At Royce, we have over 30 years’ experience matching the best
candidates to the best opportunities. We have consistently been
the Agency of Choice and have won Recruiter of the Year
2008/2009 and 2010/2011.
So if you are looking for your next career move or to find new
talent for your organisation, you can be sure that we will find
the opportunity and skills that suit you perfectly.
Hospital Specialists, Healthcare Development Managers,
Diagnostic Sales, Medical Devices, Nurse Advisor Roles, Territory
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To find out more about how our award winning
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longstanding experience within the industry, please
contact our Talent Management team:
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Healthcare and Pharmaceutical Recruitment Specialists
Follow us on
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FEBRUARY 2010
Elonva secures
EU approval
The European Commission (EC) has
approved Merck, Sharpe and Dohme’s
Elonva (corifollitropin alfa injection)
for controlled ovarian stimulation
(COS).
Elonva, the first sustained follicle
stimulant, is indicated in combination
with a GnRH antagonist for the development of multiple follicles in women
participating in an assisted reproductive
technology (ART) program.
NICE rules
Afinitor ‘too
expensive’
recommend Novartis’ everolimus
(Afinitor) for the second-line treatment
of advanced renal cell carcinoma, due
to doubts about its ability to extend life.
The Appraisal Committee decided
that, although the drug is clinically
effective, more evidence is needed to
judge whether it is a reasonable use of
NHS resources.
Patients set to
benefit from
Procoralan
(EMA) has approved a new
indication for Servier’s Procoralan
(ivabradine).
The drug is now the first and only
rate-limiting anti-anginal licensed
for use in combination with betablockers for chronic stable angina
patients for whom an optimal dose
of beta-blockers is insufficient, and
whose heart rate is above 60 beats
per minute.
Herceptin
approved in
Europe
New guideline
could save
EC approves
lives
BPH
treatment
Mepact (mifamurtide), the first new
treatment in 20 years to improve
survival in patients with osteosarcoma
(malignant bone cancer), is now
available in the European Union.
The treatment will be available via
a paid named-patient programme
in countries where it is not initially
reimbursed.
Recordati’s Urorec and Silodyx
(silodosin) have been approved for
launch in Europe for the treatment of
benign prostatic hyperplasia (BPH).
The launch of the products is
expected by the end of 2010 or
beginning of 2011.
The MHRA has questioned the
safety of the DH proposal for
Automatic Generic Substitution in
relation to immunosuppressants.
The regulatory agency has advised
that all products that contain
ciclosporin, one of four classes
of immunosuppressants, must
be prescribed and dispensed by
brand name to minimise the risk of
inadvertent switching between brands.
Orencia
approved for
GSK’s Jose to
pJIA in the EU be new ABPI
President
Bristol-Myers Squibb’s Orencia
(abatacept) has secured marketing
approval in the EU to treat paediatric
patients.
The drug has been authorised by the
European Commission in combination
with methotrexate for children with
moderate to severe polyarticular
juvenile idiopathic arthritis (pJIA).
Roche’s Herceptin has been approved
in the EU for patients with HER2positive advanced stomach cancer.
The European Commission
approval is based on results from
the international ToGA trial, which
showed that treatment with Herceptin
significantly prolongs the lives of
patients with this aggressive cancer.
A new NICE guideline on treating blood
clots in hospital patients could mark a
significant advance in the prevention of
an estimated 25,000 avoidable deaths.
The guideline sets out simple steps to
help prevent venous thromboembolism
(VTE), which covers both deep vein
thrombosis (DVT) and its possible
consequence pulmonary embolism (PE).
Mepact ‘brings MHRA doubts
hope’ to patients generic safety
Simon Jose, Senior Vice President and
General Manager of GlaxoSmithKline,
has been named as President Designate
of the ABPI.
Simon will take over from the current
ABPI President, Chris Brinsmead of
AstraZeneca (UK), on 28 April this year.
He will serve for a one-year term, with
the option of re-election for a further 12
months.
BMA against
NHS
New position
commercialisation
The BMA is urging the public to join its
‘Look After our NHS’ campaign against
commercial companies providing NHS
care in England.
Government policies have created a
healthcare market where commerciallyrun firms can compete with existing
NHS trusts and GP practices to provide
NHS care. The BMA claims that this is
having an adverse impact on many parts
of the NHS in England.
Hamish Meldrum
at ABPI
The ABPI has appointed a new Head
of Government Affairs to spearhead
its work with politicians and those
in Government in both the UK and
Europe.
Amanda Stuart, who is currently
Associate Director at Insight Public
Affairs, will take up her new role this
week. Amanda will play a key role in
communicating industry-wide messages
to politicians at Westminster and in
Europe, as well as to civil servants and
others connected with forming and
implementing government policy.
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CUSTOMER FOCUS
Can pharma respond
to the QIPP agenda?
Mike Sobanja, Chief Executive, NHS Alliance and Andy Etheridge, Commercial Director,
Cegedim Dendrite, outline the challenges facing pharma in adapting to the recommendations
of QIPP, the expected rationalisation of PCTs and the predicted emergence of GP consortialed practice-based commissioning.
C
an pharmaceutical
companies find any
positive opportunities
in a cash strapped NHS that is
going to be torn between slash and
burn tactics and the objectives of
Quality, Innovation, Productivity
and Prevention (QIPP) to meet
challenging financial targets in
2010?
Political uncertainty
notwithstanding, the NHS looks
set for serious change in the coming
years as senior managers wrestle the
budgeting challenges that must be
imposed in response to the global
economic problems.
At a most basic, organisational
level, there is little doubt that
the number of Primary Care
Trusts (PCT) will be cut over the
next few years in a bid to reduce
administrative costs and achieve
greater consistency in policy making.
The current number of 31 trusts in
London looks set to be consolidated
to eight, whilst smaller PCTs are also
likely to disappear. Realistically, the
number of PCTs is likely to reduce
by up to one third.
There is also going to be a stronger
divergence in health policy between
England and the rest of the United
Kingdom; with Wales and Scotland,
in particular, following very different
political agendas. While PCT
consolidation has already occurred in
Northern Ireland, where four trusts
have been replaced by one single
body, policies for commissioning
will be very different nationally, with
politicians in Wales and Scotland
extremely against any type of market
exposure within the NHS.
In England, by contrast, if the
Conservative Party gains power,
it is likely to follow through on
its pledge to make practice-based
commissioning a reality. This will
place budgetary control in the
hands of increasingly powerful
GP consortia, a move that will
have very real implications for the
pharmaceutical industry.
But this shift will also raise
questions about the long-term future
of Strategic Health Authorities
(SHA). With budgetary control
shifted to the GP, the PCT will be
left with the role of ensuring sound
performance management and
enforcing accountability. This will
be a clear duplication of role with
SHAs, a duplication that is unlikely
to be tolerated in what must become
an administratively leaner health
service.
Understanding QIPP
But for pharma companies, changes
in the NHS will have far greater
implications than the need to
identify a new set of Key Opinion
Leaders (KOLs). Politicians of every
party are increasingly committed to a
quality agenda and David Nicholson
is taking personal responsibility
in ensuring every PCT is defining
its new budgetary planning with
the recommendations of Quality,
Innovation, Productivity and
Prevention (QIPP) in mind.
Pharmaceutical Field February 2010
Speed of response
For NHS senior management,
QIPP is seen as the only way of
achieving the real term budgetary
cuts that must be put in place
for the next few years, without
drastically compromising the
quality of patient care. No politician
wants a repeat of the 1980s style
of slash and burn, which saw beds,
appointments and staff numbers
radically reduced.
There will undoubtedly be another
wave of pressure on spending,
including pharma spending, across
the NHS and pressure to increase the
use of generics even further. But for
pharma companies, QIPP represents
a shift away from traditional
prescribing decision making and
must have a profound impact on the
way medicines are presented to the
NHS. Critically, companies will have
to express the value propositions
for each drug in line with the
QIPP agenda; the messaging must
include information about a drug’s
ability to improve productivity by,
for example, preventing hospital
admissions and enabling patients
to more effectively manage their
conditions in the community.
Consistent messaging
In some ways, the huge emphasis
on the QIPP recommendations is
beneficial for pharma; organisations
can focus on this one, critical
challenge, as opposed to managing
the multiple challenges and
objectives that have characterised
the NHS in the past.
But pharma will also have to deal
with a far wider range of customers
within the NHS and greater
market fragmentation, especially
if the Conservative Party policy
of pushing budgets away from
PCTs and towards clinical groups
is adopted. Each PCT will have
its own QIPP interpretation and
implementation policies. Pharma
companies will have to understand
a far wider range of customers,
assess their interpretation of
QIPP and align the messaging
accordingly.
Furthermore, the move to
QIPP based messaging will be a
challenge for many companies.
Realistically, how many products
can be described as having a real
quality, efficiency and productivity
outcome?
The pharmaceutical industry has
been notoriously slow to respond
to changes in the NHS. And
although companies now admit
that the traditional rep role has
been dramatically changed by the
shift towards a more team-focused
approach, where key account
management is the new aim, it
has taken the industry 15 years
to recognise the need for a new
model.
Companies cannot wait another
15 years before adapting and
introducing the skills that will
be needed in this marketplace.
Successful pharma operations
now require individuals with
competencies that include
analytics, the ability to identify
alignment opportunities,
negotiating skills and partnership
skills. These are very different
from the traditional competencies
and will require investment and
training.
Organisations must also
address the challenges posed by
very different national NHS
strategies. With pressures on cost
and resources within each pharma
company, the objective is to create
national, even global, marketing
strategies but deliver them in a
way that can be implemented
successfully at a local level. In
the politically fragmented UK
marketplace, this will be achieved
by creating the right competencies
across the work force, but also
restructuring around regional units
and the reorganisation of company
departments within these regional
set ups.
The move to QIPP
based messaging
will be a challenge
for many companies.
Realistically, how
many products
can be described
as having a real
quality, efficiency
and productivity
outcome?
Conclusion
The pressures posed by the
NHS in 2010 and onwards will
undoubtedly pose even greater
challenges to pharma companies,
companies that are already
struggling in an extremely tough
global marketplace. Consolidation
will continue, whilst many
international companies are likely
to retrench their UK operations.
But while NHS structural
change and market fragmentation
will be key issues to address, if
pharma companies fail to express
their value propositions in a way
that reflects the QIPP agenda, the
chances for success and market
growth will be minimised.
Andy Etheridge is Commercial
Director for Direct Marketing
at Cegedim Dendrite. Cegedim
Dendrite provides value added
information, CRM and Marketing
solutions to the pharmaceutical
industry. Mike Sobanja is Chief
Executive of the NHS Alliance the only organisation that brings
together PCTs with GP practices,
clinicians with managers and board
members, and NHS primary care
with its patients.
CUSTOMER FOCUS
Think big
The benefit of
unrealistic
expectations
Are you on track to meet your targets for the first quarter of 2010? Maybe you need to set
yourself a bigger goal. Motivational speaker Dave Hyner explains.
The early part of a new year is the
perfect time to be setting goals, both
personal and professional. What do
you want to achieve? Although losing
weight, getting healthier and spending
more time with friends and family are
all popular resolutions, ‘exceed my
sales targets’ should also feature among
many Pf reader’s goals for 2010.
As the weeks progress, how far have
you come? Have you made the impact
you were hoping to make? It is not
uncommon to start the year full of
enthusiasm, but lose all motivation
amidst the cold and dark of the winter
months.
Could it be that you are not setting
the right targets? It’s time to refresh
those good intentions with a whole
new approach.
Aspiring to mediocrity
The common mantra when setting
any goal, like a sales target, is to come
up with something ‘realistic’ and
‘achievable’. Conventional wisdom
suggests this is better, because it means
the goals are easier to hit. It also says
the alternative – setting a massive,
amazing goal – can be demoralising
when people realise it’s out of their
reach.
In reality, while that may be true for
some, it just sets the majority of people
up for mediocrity – at best. How could
anyone be truly inspired and motivated
by something that is within their reach?
And don’t be fooled into thinking
realistic, achievable targets can’t be
equally demoralising. The lack of
inspiration can be just as de-motivating
– imagine how it would feel to set a
realistic goal and then not achieve it!
So if realistic goals can be
demoralising, is there really any point
in setting them? Pharmaceutical sales
is no different. In fact, the need for
a massive goal in such a pressurised,
competitive environment could not be
greater.
The rewards of a successful sales
career within the pharmaceutical sales
industry can be huge, but this means
there are more people willing to aim
for them – and to do what they have
to to get there. But there is a way to be
number one, without being completely
ruthless. I base this assertion on years
of speaking to top achievers, from
various fields including sport, business
Setting a realistic
goal just sets the
majority of people
up for mediocrity
– at best. How
could anyone
be truly inspired
and motivated by
something that is
within their reach?
and academia. They all have one thing
in common – they set themselves a
massive goal and refused to give up
until they reach it. And then they set
themselves another one.
Case studies: leading by
example
One example is sales professional Geoff
Cox, who had set up a networking
group called Network2Connect.
He implemented this goal-setting
technique – despite being sceptical
about it – and transformed his fledgling
business into an international company,
with a global reach through the website
(www.network2connect.com). He had
quadrupled his business in one year
alone.
As a young man, Poundland founder
Steve Smith was told to get a job and
a haircut or leave home. He set up a
market stall selling items for £1, to the
ridicule of friends and fellow traders.
He experienced more ridicule when
he opened the first Poundland store in
Burton-upon-Trent in 1990 – they said
costs would be too high and the prices
would give the goods a poor image.
Today Poundland has over 70 stores
around the country, employs over 2800
people and has turnover of more than
£160 million.
Sport is a field where goal-setting
has a major role to play. The late
Emlyn Hughes OBE is a fine example
of this. As a child, he set himself the
goal of playing football for England.
However, he was considered too small
to play football, so he lied about his
age to get into teams of older players,
which made him stronger than those
in his own age group. It also made
him a fierce tackler, and earned him
the nickname ‘Crazy Horse’. His
determination and drive took him
into the Liverpool and England sides
of the late 1970s and early 1980s,
becoming captain of both and the
most successful English footballer
of all time before his retirement in
1981. By that time he had played
for England 62 times and won 14
trophies, despite being ‘too small’ to
play football.
Yet another example is author
Andy Cope, who is now a best-selling
children’s writer after applying the
Massive Goals Principle. He was a
college lecturer, with the dream of
writing a children’s book about his pet
dog, Lara. His first novel Spy Dog was
published in 2005, and this has since
developed into a hugely successful
series of books, beating JK Rowling
to win the Red House Children’s
Book Award in 2006. Andy is now
an author, trainer, accomplished
professional speaker and positive
psychologist.
While these are truly remarkable
individuals, there is no reason why we
can’t all emulate their success.
Five steps to success
1. The first thing is to decide what
the goal is. What does it look like?
How will it feel to get there? Some
people choose an expensive sports
car, or a mansion, or an exotic
holiday. Others choose security
for their family, or a better worklife balance. The important thing
is to make it specific, tangible,
and quantifiable. If you need help
with this, think about people you
admire – particularly those who
have succeeded in pharmaceutical
sales. How did they get to the
top? Can you take anything from
their experience and apply it to
your own goal-setting? What
about Asa Candler, the man who
brought Coca-Cola to a global
audience, who started out as a
pharmaceutical salesman and
manufacturer? Or perhaps there is
someone a bit closer to home?
2. Secondly, think about the process.
The best approach with a massive
goal is to break it down into bitesize chunks. Once the building
blocks have been created, commit
to doing something each month to
help you hit the ultimate target.
3. You must hold yourself
accountable to your commitments.
Without accountability your
massive goal will soon fall by the
wayside. This is why the minigoals have to be measurable. But
they don’t necessarily have to be
connected to sales – it could be
something as simple as contacting
former clients and prospects, or
reading a book from an industry
expert. In other words, they
can be related to the personal
developments which will help
you reach your ultimate goal, or
generate more leads.
4. Develop some landmarks to
achieve along the way. This makes
it easier to gauge progress and
prove the goal is becoming closer.
5. And bring in some fun,
incentives or rewards to help
you. The journey may become
difficult at times, but a reward,
such as a gift for yourself, or a
city break to somewhere you’ve
always wanted to visit, will help
to focus the mind and keep you
on the path.
Follow these five steps and I guarantee
you will hit the heights – it really is
that simple! Just be clear on what you
want to achieve and what you need
to do to get there. This is the only
way you will become the number
one pharmaceutical salesperson in
your company or therapy area. If you
continue to set achievable goals you
will only ever get to mid-table, and
you’ll never reach your full potential.
Let’s make 2010 your most successful
year ever!
Dave Hyner is a Staffordshire-based
motivational speaker and Managing
Director of Stretch Development.
He has travelled the world to deliver
keynote addresses on his research into
top achievers in sport, business and
academia.
A wide range of case studies and
testimonials, along with a video of
David in action, are available at the
Stretch Development website:
www.stretchdevelopment.com.
- Voted No 1
Selection of the fittest!
The evolution of CHASE from recruitment agency to a highly rated and
widely recognised UK Contract Sales Organisation (CSO) has taken place
over a 12 year period.
“Evolution is a good word to use to describe our development,” says Chris
Phillips, Managing Director of CHASE. “Like all successful life forms, we have
adapted quickly to a changing business environment, aggressive competition
and a fast-moving landscape. Throughout this journey, we like to think that
our DNA has always remained the same – we believe our unique structure
allows us to deliver quality in everything we do.”
“Many members of our team have over 10 years’ service and all of us are
experienced from within the pharmaceutical industry – we believe that a
high level of consistency and applied experience is what our customers really
value. Building long-term client relationships are an important element to our
team of consultants. At CHASE we really understand and support our client
strategies and have developed strong strategic partnerships.”
The quality approach of CHASE permanent recruitment is well documented by
their customers:
“Following on from my CSO experience with Schering Plough through
CHASE, I just wanted to drop a note of thanks for the excellent support
CHASE has provided to date for my current campaign. Firstly, I have been
sent a consistent list of good candidates; I have even turned some people
down that on normal circumstances I would have been happy to progress.
In particular, CHASE has excelled in the ‘service’ offered.” Tom Harrington –
NSM
“Having given a tight brief as to the specific qualities of the candidates I
required, CHASE only delivered candidates who met this brief, which saved
me enormously on screening unsuitable candidates and made it much easier
to find the right people I was looking for.” Simon Davis – Southern Sales
Manager
Ability to Adapt
Certainly the market landscape has changed beyond all recognition in this
timeframe: the constantly developing NHS with its demands and formularies,
the endless M&A activity, the reduction in headcount and focus shift to key
accounts and secondary care. This competitive landscape is littered with the
fossils and skeletons of evolutionary failure – those companies that did not
change and attempted to carry on ‘business as usual’ were always going to be
doomed to extinction.
“Of course our adaptability is crucial, however, it is the our people and values
that sets CHASE apart,” says Judy Phillips, Recruitment Director.
Adapting to the times is critical; it’s also true that keeping some standards
absolutely unchanged is equally important. Our candidate quality remains
uncompromised over the last 12 years – we always interview every
candidate and complete competency based interview notes. CHASE also
remains unique in that we never, ever subcontract contract or permanent
recruitment. We know from client and contractor feedback that these things
really matter:
“Having experienced working with Chase previously I didn’t hesitate when
another opportunity came along to work with them again. As a medical sales
representative I expect a CSO provider to offer complete & professional
care. CHASE exceeds this expectation with an efficient and personable
approach.” Dawn Hewitt CHASE/ MSD – Medical Representative.
accolades from the industry – with
an impressive list of awards and
recognition:
• Pharmaceutical Field – Recruiter
of the year 2010 *
• PharmaTimes – Recruiter of the
Year 2007 / 2009 **
• PharmaTimes – Agency of the
Year 2007, 2008 and 2009 ***
• Pf Awards – Clinical Nursing
Award Winner (CHASE / Abbott)
2009/10
* As voted for by respondents to the Pf Company Perception, Motivation and Satisfaction Survey 2010
** PharmaTimes Sales Recruiter of the Year 2007/2009
*** PharmaTimes Most Nominated Recruiter of year 2007/2008/2009 - Sales Category
Flexible Resourcing
Evolution is about constant variation and, like all successful organisms, CHASE
has adapted and diversified in order to satisfy customer requirements. Over
the years, by listening closely to customers’ needs as they plan strategies,
it became clear that flexibility in sales resourcing was becoming increasingly
important. This led to the development of distinct divisions with specialised
offerings CHASE VM, CHASE Flex and CHASE Graduates – all responsive
developments to improve client competitiveness in tough environments. CHASE
VM provides high quality vacancy management allowing client businesses to
manage the challenges of short and long term territory vacancies.
“Sticking to the brief is the key – we’ve used CHASE for vacancy management
and recruitment for a number of years – I love the ‘no time wasting, right
candidate, right job’ approach. The CHASE VM team understand precisely the
skills and experience that we’re looking for here, and they have delivered every
time.” Ken Shields – Head of Endocrinology and Gastroenterology
Meanwhile, CHASE Flex offers that operational flexibility needed by so many
sales teams as they maximise the opportunity of differential resourcing, whilst
CHASE Graduate offers a real ‘try before you buy’ scheme for trainees and new
entrants.
“Speed is a crucial factor in managing our vacancies and I’ve been amazed,
quite frankly, at how quickly CHASE VM has placed the right high-quality
people for us. We treat CHASE VM as a true partner – and the relationship
is important from both sides. There’s no doubt in my mind that having
open communication with a senior director and team who understand
our needs and respond with real urgency makes real difference.” Stuart
Shotton – Sales Director
Our Focus
If you want to measure our evolution, then CHASE is reflecting the market
with 80% of our contract and permanent activity in secondary care, key
account work and Market Access. Additionally, we have seen our CSO
business grow by 48% last year, which is unprecedented in the CSO sector.
CHASE is providing clients with a real alternative choice in the CSO market
and they appreciate the quality of our candidates and focus we can offer.
There is doubt that CHASE has thrived and survived by getting involved
and listening to our clients needs – it is only by working in close
partnership that we can create tailored services. Consistent quality in
service, in both permanent and contract offerings, remain the hallmark of
our business.
If you’d like to discuss how CHASE can help you
with recruitment, specialist contract teams or vacancy
management, then please call us on 0131 553 6644 or
email us at [email protected]. For more
information, visit: www.chasepharmajobs.com.
COMMISSIONED PROFILE
CHASE has also won a string of
MARCH 2010
Report calls for review of
NICE’s processes
Around 16,000 patients have
been denied access to important
treatments that could have
prolonged their lives, latest
findings have revealed.
A new report from the Rarer
Cancers Forum has highlighted
continuing problems for people
with rarer cancer in accessing
treatment.
Preparing for
stormy weather p14
March 2010
Oscars for
outcomes p26
Playing the
game p16
Report demands urgent
review of NICE’s processes
Around 16,000 patients have been
denied access to important treatments
that could have prolonged their lives,
latest findings have revealed.
A new report from the Rarer Cancers
Forum has highlighted continuing
problems for people with rarer cancer in
accessing treatment.
Exceptional Progress? Assessing the
progress made in improving access to
treatment for people with rarer cancers
found that, though progress has been
made, with many patients being given
vital treatment, thousands are still being
denied access to life-saving treatments.
Since NICE promised to improve
access to drugs for rarer cancers, four
drugs that meet this criteria have been
denied funding, while draft guidance
recommends against NHS use of
another six. Just five have been accepted.
The report argues that NICE is taking
too long to appraise new cancer drugs –
21 months, rather than the six months
promised by ministers. Andrew Wilson,
Chief Executive of the Rarer Cancers
Forum, said: “Although progress has
been made in improving access to cancer
treatments since the publication of the
top-ups review, there is still more to do.
It is unacceptable that many thousands
of patients are still missing out on the
treatment they need, and which their
doctors want to give them, because
NICE has decided that their treatment
However, patient groups have cited
NICE’s recent rejection of everolimus,
an effective new kidney cancer drug
that met the ‘end of life’ criteria, as
evidence against this statement.
Rose Woodward, Head of Patient
Support at The James Whale Fund,
said: “What is the point of sons and
daughters and friends and families
running relays and holding coffee
mornings to raise funds for cancer
research if new drugs aren’t available
to NHS cancer patients? It’s morally
wrong that these new drugs can
only be prescribed to rich patients
or patients who have private health
insurance.”
does not meet some arbitrary criteria.
The changes introduced by NICE
should be benefitting more patients
than they are doing at the moment. An
urgent review of NICE’s processes is
needed.”
In cases where appeals were raised
by individual patients to gain access
to a drug, inequalities across the UK
were revealed, as out of 62 PCTs, 11
approved all drugs, two approved none.
In response, Sir Andrew Dillon, Chief
Executive of NICE, said: “We have
introduced significant additional latitude
in our appraisal of treatments for cancer,
particularly where they are designed to
extend life, at the end of life.”
‘Disappointing’ progress on health inequalities
Health inequalities between the poor
and the wealthy are worsening, despite
overall health improvements, a new
Audit Commission report has shown.
Healthy Balance revealed that
although there has been progress,
including cuts in infant mortality and
increases in life expectancy, this has
coincided with a widening gap between
the poor and the better off.
It recommends that PCTs comply
with public health guidance from
NICE to cost-effectively reduce health
inequalities.
The Commission estimates that
in 2009/10, the NHS allocated £21
billion to PCTs to reflect differences in
health inequalities. However, among its
conclusions, the report suggests there
may have been too much policy and
guidance for PCTs and local authorities
to keep up with.
Andy McKeon, the Audit
Commission’s Managing Director,
Health, said: “We know the health of
(Continued on p5)
PF-MARCH NEWS.indd 1
Health briefing March 2010
Healthy balance
A review of public health performance and spending
The health of people in England
has improved over the past
ten years. Life expectancy has
increased, infant mortality has
fallen. Government targets to
cut death from heart disease
and stroke by 2010 have already
been met. But if the big picture is
positive, stark problems remain.
Inequalities in the health of people
from certain areas and social
backgrounds has stubbornly
resisted improvement, and has
even increased in some cases.
A potent measure is the gap between the worst
areas and the England average. This is captured
in the difference between the England average
and performance in the spearhead local strategic
partnerships (LSPs), the one-fifth of areas with
the worst rates of deprivation and early death. On
that measure, the gap in death rates for both men
and women rose between 1998 and 2007 – from
16.1 per cent to 18.6 per cent and from 13.9 to
15.2 per cent respectively. For infant mortality,
the gap at first narrowed and had been on course
to meet the government’s target – a 10 per cent
reduction by 2010 from a 1998 starting line. But
the latest figures show little improvement during
the past four years (Ref. 1).
18/03/2010 12:27
Health
inequalities
increasing
Marketing
award for
Schering-Plough
Health inequalities between the poor
and the wealthy are worsening, despite
overall health improvements, a new
Audit Commission report has shown.
Healthy Balance revealed that
although there has been progress,
including cuts in infant mortality and
increases in life expectancy, this has
coincided with a widening gap between
the poor and the better off.
Schering-Plough has been named as
Best Medical Supplier at this year’s UK
Marketing Excellence Awards.
The company fought off competition
from 3M Drug Delivery Systems,
Mediplus and Nutricia Advanced
Medical Nutrition to win the award,
which was partly judged by Natalie
Uhlarz of Pharmaceutical Marketing.
Health briefin
g March 2010
e
Healthy balanc
A review of publi
c health perfo
rmance and
spending
d
people in Englan
The health of
over the past
has improved
expectancy has
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mortality has
increased, infant
to
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fallen. Govern
e
heart diseas
cut death from
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and stroke by
is
if the big picture
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the
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has stubbornly
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and performa
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On
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of deprivation
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the gap in death
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and 2007 – from
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16.1 per cent
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15.2 per cent
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show little improvem
the latest figures
years (Ref. 1).
the past four
EMA and
FDA agree
annual report
(EMA) and the US Food and Drug
Administration (FDA) have agreed to
accept a single annual report for orphan
drugs for use in both the EU and the US.
The announcement coincides
with World Rare Disease Day (28th
February), which seeks to call attention
to rare diseases as a public health issue,
and to reinforce the increased need for
access to information, research and
treatment.
Pharma and
biotech top
R&D
The pharmaceuticals and
biotechnology sector dominated UK
R&D spending in 2008, the latest
R&D scoreboard has revealed.
Around 80% of UK R&D was
conducted by just one hundred of
the top R&D investing companies,
many of which operate in the
pharmaceuticals and biotechnology
sector.
To read the
full story, click
on the headline
Abbott
completes
Solvay deal
NICE should
retire old drugs,
says article
Abbott has completed its EUR 4.5
billion acquisition of Belgium-based
Solvay Pharmaceuticals.
The takeover provides Abbott with a
large and complementary portfolio of
pharmaceutical products and expands
its presence in key global emerging
markets.
The methods for abandoning old
drugs in favour of new ones must be
improved, experts have warned.
Writing for the BMJ, health
academics Dyfrig Hughes and Robin
Ferner said that decisions about
which drugs to abandon to fund new
treatments recommended by NICE are
inconsistent and may be contributing
to the postcode lottery – one of the key
issues that NICE was set up to tackle.
Forbes reveals
the world’s
most expensive
Miles D. White
AZ cuts UK
R&D
Up to 1,000 workers will lose their jobs
at AstraZeneca as the company closes
two of its research facilities and ends
development in various disease areas.
AZ’s R&D site at Charnwood in
Leicestershire is to close, as well as a
smaller facility in Cambridge. The
company also intends to end R&D work
at its Avlon facility near Bristol. Some
workers will move to AZ’s largest R&D
site, Alderley Park in Cheshire.
Specialty drugs for rare diseases have been
shown to be the most costly, according
to market and analysts’ data gathered by
Forbes magazine.
Alexion Pharmaceuticals’ treatment for
paroxysymal nocturnal haemoglobinuria
(PNH), Soliris (eculizumab), came top
of the Forbes’ list of the top nine priciest
drugs on the current global market.
HAVE YOUR SAY
NICE restricts RA options
NICE has published three
recommendations that could
“drastically limit” the treatment
options available to patients with
severe rheumatoid arthritis (RA).
NICE’s latest ruling against funding
tocilizumab (RoActemra) came only
a day after a negative decision on
abatacept (Orencia) as a second-line
treatment and restrictions were placed
on the use of three other antiTNF drug therapies (adalimumab,
etanercept and infliximab).
Alisa Bosworth
MARCH 2010
Retacrit
Diversity the
Vidaza decision
key for pharma, secures EU
appealed
recommendation
report says
Top pharmaceutical and biotech
companies will face a major decline in
sales growth up to 2014, according to a
new report.
However, those companies that have
been able to diversify into biologics,
niche products and generics will still
enjoy positive growth, says business
analyst Datamonitor.
Retacrit is to become the first
biosimilar of epoetin to achieve
a subcutaneous licence in renal
patients.
The biosimilar, manufactured by
Hospira, received a positive opinion
from the CHMP for subcutaneous
(SC) use in renal anaemia.
Flu vaccine
secures
recommendation
UCB partners
NHS to
provide Cimzia
NICE has finalised its revised Cimzia
(certolizumab pegol) guidance,
recommending the treatment for some
people in England and Wales suffering
with rheumatoid arthritis.
The recommendation is another
example of a negative NICE decision
being reversed due to a patient access
scheme agreed with the manufacturer.
The CHMP has recommended a
conditional marketing authorisation
for a fifth pandemic influenza vaccine
– Humenza from Sanofi Pasteur.
This is the second pandemic vaccine
to be assessed by the Committee using
an emergency procedure which fasttracks the evaluation of new vaccines
developed during a pandemic.
Government
invests in cancer
UK boost for
campaigns
Intercell
The Government has pledged
£8 million to help local NHS
organisations fund campaigns that
improve early diagnosis of cancer.
The investment follows the Prime
Minister’s pledge to ensure that all
patients with cancer symptoms receive
their results from diagnostic tests
within one week.
Charity calls to
end scheme
AML
candidate
recommended
The MS Society is campaigning for
an end to a scheme that gives multiple
sclerosis patients access to drugs that are
not recommended by NICE.
The Risk Sharing Scheme, which was
to run for ten years, was implemented
by the DH in 2002 when NICE
decided that certain disease-modifying
drugs were not cost-effective. The drugs
involved are Biogen Idec’s Avonex, Bayer
Schering Pharma’s Betaferon, Teva/
sanofi-aventis’ Copaxone and Merck
Serono’s Rebif.
Celgene UK has appealed NICE’s
decision against the use of Vidaza
(azacitidine) in patients with higher-risk
myelodysplastic syndrome (MDS), a
rare type of blood cancer.
NICE has concluded that the drug
does not represent a good use of NHS
funds, though it is reimbursed in this
indication in most other European
countries.
(EMA) has recommended orphan drug
status for an acute myeloid leukaemia
(AML) treatment under development
by Swedish biotech company Aprea.
The drug is currently undergoing
a Phase I clinical study and a
final decision from the European
Commission is expected in a few weeks.
The Joint Committee on Vaccination
and Immunization (JCVI) in the UK
has recommended the use of Intercell’s
Ixiaro to protect people at high risk of
contracting Japanese Encephalitis.
Ixiaro is recommended for individuals
aged 18 years and older that are at high
risk of exposure during travel or in the
course of their occupation.
BMS reveals
new CEO
Bristol-Myers Squibb has announced
that Lamberto Andreotti will
take over as the company’s Chief
Executive Officer when current
Chairman and CEO James M.
Cornelius retires.
Andreotti, who is currently
President and Chief Operating
Officer, has served with BristolMyers Squibb for 12 years in senior
leadership roles, both internationally
and in the US. Prior to joining
Bristol-Myers Squibb, he held senior
roles at KABI Pharmacia and then at
Pharmacia & Upjohn.
Forum to
combat drug
shortages
The onus to ensure there is a sufficient
supply of medicines to the NHS
will be placed on manufacturers and
wholesalers, health ministers have
decided.
A package of tough new actions
was agreed at a summit to discuss
current difficulties with the supply of
medicines, hosted by Health Secretary
Andy Burnham and Health Minister
Mike O’Brien.
Unique ITP
treatment EU
approved
A new treatment for immune
thrombocytopenic purpura (ITP) with
a unique mode of action has been
approved for marketing in the EU.
The EMEA has granted a
marketing authorisation for Revolade
(eltrombopag), the first oral
thrombopoietin receptor agonist (TRA)
to be approved for this patient group.
Preparing for stormy weather
The NHS Operating Framework 2010/11
Is the NHS now at a critical juncture in its history? How will it operate in the incoming
financial storm? Alan Jones reports.
T
he NHS New Year has now
started and the NHS modus
operandi for the year ahead is
now live. An important document at
the moment is the Operating Framework
for the NHS in England for 2010/11,
published last December, which sets out
the priorities for your NHS customers
over the next 12 months – particularly
for payers. These key priorities will have
a significant impact on your business
this year. The full document is 52 pages
long, but this article will highlight some
key areas, as well as provide some ‘takehome’ points.
Planning for the tough financial
climate ahead is at the heart of this
year’s Operating Framework. There will
be some growth in 2010/11 but a big
freeze will follow, where up to £30bn
of efficiency savings are required. The
UK economy may be emerging from
the recession, but the NHS is just
about to enter one. So, although the
national priorities largely remain the
same, a number of shifts in national
policies are set out. Hospital-based care
particularly will be restructured (and
even downsized) and management levels
are to be reduced.
Hard times ahead
Implications for hospitals
Earlier this year, Pf published a piece
on the white paper NHS 2010-15; from
good to great. This new five-year NHS
Plan mapped out a slight change of
direction by Government, who had to
acknowledge the incoming cold financial
winds. This year’s operating framework
is year one of its implementation.
There will be difficult times ahead
for hospitals because big changes are
planned to ‘payment by results’, the
acute sector’s financial lifeblood. The
more accurately titled ‘payment by
activity’ has encouraged overheating in
the hospital sector and driven up costs.
And despite the focus on care closer to
home, hospitals have expanded, with the
numbers of consultants growing faster
than GPs. So there are some hard hitting
measures to cut the cost and number of
hospital procedures.
A new two-part NHS tariff capping
system will be introduced, where a set
level of emergency procedures will be
paid for at full tariff price but over that
volume hospitals will only get 30%.
Tariff prices are also to be frozen and
the only extra income (apart from
increases in volume for elective care)
will come through the Commissioning
for Quality and Innovation (CQUIN)
scheme. Hospital income will depend
on improving the patient experience,
and PCTs will be handed the power to
withdraw payments where they judge
that care is below par.
‘Best practice’ tariffs (probably at a
lower price) are also being introduced
to ensure the highest quality care. These
changes to the tariff are designed to
reward quality but also incentivise care
outside hospitals. The net result of all
of this may be that hospitals become
trapped in a rather uncomfortable
‘pincer movement’ where they will have
to drive down costs while their activity
levels also fall. There are predictions that
hospitals could run up deficits of around
£7.5bn a year by 2015. To balance the
books, cuts in ‘heads and beds’ might be
necessary. The tariff moves are another
attempt to shift the balance of power
away from Acute Trusts towards PCTs
as commissioners; while the marginal
tariff is clearly an attempt to force a
discussion about risk-sharing in relation
to unplanned admissions and improving
demand management. There is also
something extraordinary about giving
Foundation Trusts the opportunity to
run community services.
The focus is on vertical integration
between acute and community services.
There will be a new deadline for all
hospitals that are not yet foundations to
submit their timetable for achieving this
Pharmaceutical Field March 2010
“The Operating
Framework challenges
all organisations to
reduce overheads and
management costs…
it is now time to
tackle those things we
have known about in
the system for a long
time…”
Sir David Nicholson, page
2, 2010/11 NHS Operating
Framework for England, December
2009
status by 2013/14 – otherwise they risk
takeover by another Trust. This all points
towards some major ‘turbulence’ in this
sector; we will see more mergers and
possibly wholesale hospital closures.
Implications for
commissioners
The NHS will face its biggest financial
challenge in the next generation and
the document suggests taking costs
completely out of the system – including
admin costs, commissioning costs and
management costs. NHS managers
will take a hit again, as there is a target
for PCTs and SHAs to reduce their
management costs by 30% over the next
four years.
Although it is not long since PCTs
faced ‘the night of the long knives’ (in
2006/7, when the current number of 152
PCTs was created), this level of savings
could result in management functions
being merged with other organisations
and up to 6,000 PCT and SHA jobs
could go. And yet the DH wants
commissioning to significantly improve.
Other commentators are arguing that
up to £1.5bn is wasted on ineffective
interventions, so there will be a greater
focus on the decommissioning of services
and treatments that bring little benefit to
patients.
The document also contains a
renewed emphasis on prevention,
integration of care, care closer to home
and self care for long-term conditions,
which are also seen as reducing costs.
However, an Audit Commission report
last year suggested that PCTs have
made little inroad into transferring care
from hospitals to the community and
the annual 2009/10 report from the
National Quality Board showed that
high hospital admission rates in areas
like COPD and diabetes are a measure
of the (lack of) quality of primary care.
So there is still a lot of work to be done.
The Operating Framework points
out that care closer to home would
achieve better outcomes and save
money – up to £2.7 billion a year. So
there is likely to be new pressure on
consultants and GPs to agree local
care pathways and more consultants
working in the community. In primary
care, there will be major reforms to
QOF from 2011 (less money and
harder targets) with the ‘regulation’
of GPs by the CQC to follow. There
is even a suggestion that the GMS
contract might need to be renegotiated
to return it to a 24/7 service. There
will also be more focus on primary care
resource usage, with tougher sanctions
for those with unjustifiable spends and
a particular focus on prescribing.
Conclusions
Thus concludes our quick tour of the
NHS until April 2011. There may be
an upcoming election, but whoever
is in power this June will still have to
deal with the impending NHS funding
crisis and these plans are unlikely to
substantially change over the shorter
term. This Government is now saying
that the urgent £15/20bn savings
will no longer be ‘cashable’ savings,
but a reinvestment in ‘front line’
services, to cope with rising demands.
The key message is that after years
of unprecedented growth, the NHS
now faces a period of unprecedented
austerity. Prepare for a bumpy ride.
Alan Jones is an occasional contributor
to Pf. He commentates and presents
widely on the ongoing reform within
the NHS and its implications for
pharma and is a consultant to
Wellards. An independent healthcare
policy analyst, adviser and NHS
trainer, he can be contacted at
[email protected].
Ten key take-home points
1. Policy documents like this come out with great regularity. Have
you been briefed internally as to its implications for you? How
does this work in your company? Certainly this document is
an organisational ‘must-read’ and a detailed analysis is required.
Chapter 3 is the key section (pages 27-43).
2. Acute Trusts are likely to feel the icy cold winds of recession
first. Significant reconfigurations are likely. Is it time for ‘real’
account management in hospitals, rather that just KAMs
working a few selected (key) hospitals (accounts)?
3. Expect the numbers of PCTs to fall, but do not pull back on
your payer liaison activities or hesitate to start them. For good
account management reasons, perhaps even intensify them.
4. PCTs are highly unlikely to be able to afford all the treatments
recommended by NICE, so new drugs will face stiffer market
access challenges, even when they are NICE approved. Expect
NICE to be tougher in its decision-making.
5. There could be significant change coming in primary and
community care. There will be increased community delivery
of specialist drugs and even tougher formularies. PCT
prescribing budgets will be expected to make savings.
6. There is now a recognition that healthcare has become too
fragmented. Integration is a key theme in the document, so
expect both vertical and horizontal integration to occur – new
accounts needing new account management strategies.
7. There is to be even more joint working with local authorities and
even mergers, such as that in Herefordshire and some London
boroughs. Most Director of Public Health posts are now joint
ones. What do companies know about social services and elected
councilors?
8. Perhaps for the first time ever, there is an explicit suggestion that
the local NHS should ‘work in partnership with the life science
industry’. How will you avail yourself of the major opportunities
here?
9. There will need to be more focus on care pathways, with
companies prepared to work across the purchaser/provider divide.
How many companies are set up for this? Clinical networks in
areas like CHD and diabetes are new accounts. NHS-alignment
of sales and marketing strategies will be key.
10. Finally, there seems little confidence that the cushion of recent
huge funding increases has put the NHS into any stronger
position to weather the incoming financial ‘storm’. The only real
way to save money is to spend less. That might not only mean
fewer staff and but also less medicines use.
Pf Awards 2010:
Oscars for Outcomes
Pharmaceutical sales’ equivalent of the Oscars, the Pf Awards 2010, recognised the brightest
and best sales talent the sector has to offer. During a time of transition, and sometimes
uncertainty, the Awards provide an opportunity to celebrate the achievements of a successful
industry with patient outcomes at its core.
T
his year’s Pf Awards Dinner
was once again a memorable
night. Held at the sumptuous
Lancaster London Hotel near Hyde
Park in London (March 11th), the
event was attended more than 550
sales and marketing professionals from
across the industry. These included
not only the sponsors and judges, but,
most importantly, hundreds of nervous
candidates and their excited colleagues,
all looking as if they could have graced
the red carpet of the previous week’s
premier event, the Oscars.
Much like the Oscars, emotions
were high amongst the evening’s
attendees, as they shared their
experiences of the assessment day
and caught up with old friends at the
pre-awards champagne reception.
Prior to the awards dinner and official
ceremony, an award of a different kind
was presented: the Pf Employer of
Choice. Each year, Pf asks respondents
to its Company Perception,
Motivation and Satisfaction Survey
to vote for their Employer of Choice
– this is the company they view as
the most desirable to work for, not
including their current employer.
The Winners
Award Category
Experienced Hospital Representative
Ethical Leadership in Sales
New Representative
Account Manager
Clinical Nursing
Learning and Development Initiative
IMS Business Simulation
Cross-functional Partnership
Nurse Manager
New Hospital Representative
Business Manager
Partnership Leader Award
Account Team
Experienced Representative
Outstanding Performer
Winner
Company
Louise Finke
Paul Sandhu
Irene Harvey
Charlene Ward
Tracey-Anne Blanc
Charlie Crabtree
Laura Rosenthal
Anthony Peers
Caroline Gadd and
Christian Rimmer
Leigh Thomson
Anthony Peers
Ian Saunders
Farrah Ahmad
Elizabeth Albon and
Allison May
Alison Dixon
Alison Dixon
Shire
Schering-Plough (a part of MSD)
Janssen-Cilag
Abbott
Ashfield In2Focus on behalf of Takeda UK Ltd
Chase / Abbott
Quintiles
National Services For Health Improvement Ltd
Quintiles
Pfizer
Chiesi Ltd
Pfizer
Pfizer
“The Awards just get
better every year. It was
a superb evening, and
James Cracknell was
a great choice for cohost – his achievements
stand as an excellent
example to anyone
hoping to go the extra
mile. Congratulations
must go to all our
winners, who did just
that, particularly our
Outstanding Performer,
Alison Dixon.”
Melanie Hamer – Pf Awards
Forthe second year running, the
Employer of Choice was Boehringer
Ingelheim, and its National
Operations Manager Dominic Timney
gratefully received the award from
Heidi Sharland, General Manager of
Pf publisher, Health Sector Publishing.
Dominic Timney said: “The Pf Awards
evening is a tremendous event and this
year was a night I will remember for a
long time. Boehringer Ingelheim has
won the Employer of Choice Award
for the second year running. It’s an
exceptional achievement and it was a
privilege to receive the award on behalf
of all my colleagues and friends at such
a great company.”
The official ceremony opened with
a presentation by the guest host,
Olympic gold medal winner and
world record holder James Cracknell.
An accomplished public speaker, he
spoke on preparation and the build-up
to an important challenge, as well
as entertaining the attendees with
anecdotes from his experiences at the
Beijing Olympics. Another winner
to address the audience was former
England footballer and 1966 World
Cup hero Sir Geoff Hurst. In his
capacity as the current President of
Sparks, the children’s medical research
charity and the Pf Awards’ nominated
charity for 2010, Sir Geoff thanked
the Pf Awards for their support via a
pre-recorded video message. In total,
£1000 was raised on the night for the
charity.
And the winners are...
The awards were presented by Pf
Awards Events Director Melanie
Hamer and co-host James Cracknell,
with the sponsor of each award
announcing the winner. The top
performing candidates represented
a variety of companies and were
deployed across a range of roles from
within the pharmaceutical sales
industry. In addition to the overall
winners, commendations were
announced for those candidates that
achieved full marks in one part of their
assessment.
The Pf Awards’ main success story
on the night was Schering-Plough,
now a part of Merck, Sharpe and
Dohme, which came away with four
awards – the highest number won by
one company. These included one
of the night’s most desired awards,
Experienced Hospital Representative,
but also two newer categories, the
Cross-functional Partnership and
Partnership Leader awards, which
recognise when candidates have
engaged in a partnership with a
customer that has made a significant
difference to patients.
Another big winner was pharma
giant Pfizer, boasting this year’s
Experienced Representative and
Outstanding Performer Alison
Dixon, two of the most coveted
awards of the evening. Alison
described her feelings on the night:
“It was a really special evening, but I
don’t think the enormity of winning
really hit me until the next day,
when I was inundated with calls
from colleagues to congratulate me,
even from people I didn’t know. In
such a competitive environment,
it was amazing to get that kind of
recognition from colleagues that I
admire.”
“The whole experience was a really
positive one from me, right through
from the assessment day to the
awards evening,” Alison added. “This
was my first entry into the Pf Awards
so I didn’t know what to expect, but
it was a real compliment even to be
nominated considering the calibre of
the other candidates, even just those
from Pfizer.”
APRIL 2010
New NHS board to champion EU approval
innovation
for Duodart
A new NHS Life Sciences Innovation
Delivery Board (LSIDB) has been set
up to champion innovation in drugs
and medical technologies.
The LSIDB aims to increase the
use of cost effective treatments,
improve relationships between the
life sciences sector and the NHS and
increase the attractiveness of the UK
as a site for clinical trials and product
development.
Commercial skills
for the NHS p12
April 2010
New title, same
job? p22
US health
reform p18
New NHS board will
champion innovation
A new NHS Life Sciences
Innovation Delivery Board (LSIDB)
has been set up to champion
innovation in drugs and medical
technologies.
The LSIDB aims to increase the
use of cost effective treatments,
improve relationships between the
life sciences sector and the NHS
and increase the attractiveness of the
UK as a site for clinical trials and
product development.
NHS leaders, regulators (NICE),
senior policy makers and industry
leaders from the life sciences sector
will work in collaboration for the
benefit of patients.
The aim of the Board is to ensure the
NHS and industry can work together
to share information, which will
ultimately lead to improved services.
It is hoped that an effective
partnership between the NHS and
industry will help the NHS to increase
quality and productivity and enable
industry to develop new therapies
that meet the needs of the NHS and
patients.
Mike Farrar, Chairman of the Life
Sciences Innovation Delivery Board,
said: “This is an exciting and important
initiative for the NHS. It’s hard to
think of a more significant, mutually
reliant relationship that is conducted
under such difficult circumstances.
“The aim of this new Board is to
Mike Farrar
enable the life sciences industry and the
NHS to work together in collaboration
for the benefit of patients. This can
only be good news for all parties
concerned.”
NHS plan to develop commercial skills
New NHS Commercial Support
Units will help local and regional
decision-makers to support the quality
and productivity agenda by building
effective relationships with suppliers
and independent health providers, a
new DH publication explains.
Commercial Skills for the NHS sets
out a strategy for supporting NHS
staff to develop their commercial
skills, and for supporting local
commissioners and providers with a
new commercial infrastructure.
The document makes it clear that
the new infrastructure for NHS
commissioning and procurement has
the overarching goal of supporting a
shift from hospital care to healthcare
in the community.
The role of the Commercial Support
Units in helping PCTs and SHAs to
relate more effectively to the range of
product and service providers on the
ground, as well as to the structures
(such as NHS Supply Chain) that are
seeking to rationalise procurement
activity at national level, is explained.
Commercial Skills for the NHS
supersedes Necessity not Nicety
– a new commercial operating
model for the NHS (May 2009),
clarifying the new infrastructure
and indicating that the ‘preferred
provider status’ of the NHS does
not impede open competition for
franchises in the redesign of service
provision.
The goal of Commercial Skills
for the NHS is to clarify the role
of the Commercial Support Units
in supporting service redesign at
local and regional level, driving
changes in commissioning and
procurement to support quality
and productivity – and thereby
opening doors for innovative
suppliers and independent health
providers.
Looking around?
GSK has secured European approval
for Duodart (dutasteride and tamsulosin), the first fixed dose combination
medicine for benign prostatic hyperplasia (BPH).
Approval for the drug was given
via the Decentralised Procedure, with
Germany acting as Reference Member
State.
For the very latest vacancies in pharmaceutical sales
and the news stories that matter most
it’s wise to visit www.pharmajobs.co.uk
PF-APRIL10-NEWS.indd 1
15/04/2010 14:36
Teva to become NHS to develop
leading generics commercial
company
skills
Teva has outbid Pfizer for
ratiopharm, the sixth largest generic
drug company worldwide.
The deal is valued at EURO
3.625 billion and is expected to be
completed by the end of the year,
dependent upon certain conditions,
including relevant regulatory
approvals.
Shlomo Yanai
High Court
success for
Servier
The High Court has ordered NICE
to issue new guidance in relation to
Protelos within three months, following
an appeal by the drug’s manufacturer
Servier Laboratories.
It has been ruled that NICE should
not have rejected Servier’s clinical data
on the reduction of risk of hip fracture
by its osteoporosis treatment and
was therefore unlawful in its decision
making.
New NHS Commercial Support
Units will help local and regional
decision-makers to support the quality
and productivity agenda by building
effective relationships with suppliers
and independent health providers, a
new DH publication explains.
Commercial Skills for the NHS sets
out a strategy for supporting NHS staff
to develop their commercial skills, and
for supporting local commissioners
and providers with a new commercial
infrastructure.
Pharma
employees
more loyal
A quarter of employees in the
pharmaceutical sector are more loyal
to their employer as a direct result of
the economic downturn, according
to a recent survey.
The research, by global workforce
solutions leader Kelly Services,
shows that the economic recession
has generated a clear and powerful
sense of engagement between
workers and bosses.
Follow Pf on Twitter
@PharmaField
EMA reviews
2009
received 96 applications for
marketing authorisations for
medicines in 2009, 60% higher than
the initial forecast.
At its recent meeting, the EMA’s
Management Board also reported
that it consistently met regulatory
timelines and delivered good results
in 2009, despite resources being
diverted to deal with the H1N1
pandemic.
Novartis and
Roche threaten
to leave UK,
report claims
Eddie Gray
Code
complaints
down in 2009
Last year saw the lowest number of
complaints in relation to the Code of
Practice since 2004, according to figures
published by the PMCPA (Prescription
Medicines Code of Practice Authority).
There were just 92 complaints against
companies in 2009, compared to 112 in
2008, 127 in 2007, 134 in 2006, 101 in
2005 and 119 in 2004.
Novartis and Roche have reportedly
threatened to remove their
operations from the UK, due to
NHS pricing and restrictions placed
on UK clinical trials.
The accusations, reported in
the Guardian, were apparently
made in private meetings between
the companies and Government
Ministers, including Health Minister
Mike O’Brien.
To read the full
story, click on
the headline
Rare disease drugs available
on NHS
Patients with very rare
conditions will be given access
to drugs and services not
previously available on the
NHS, the DH has announced.
A small number of drugs
and treatments for very rare
conditions that are not yet
appropriate for the NICE
appraisal process can now
be considered for use in the
NHS.
Mike O’Brien
APRIL 2010
Patients to
Resolor
launched in UK benefit from
Xeloda
Movetis’ Resolor (prucalopride) is
now available in the UK to treat the
symptoms of chronic constipation in
women who do not receive adequate
relief from laxatives.
Resolor is a novel enterokinetic
agent that represents a new approach
to the treatment of chronic
constipation as it targets underlying
impaired gut motility.
NICE backs
limited use of
Multaq
NICE has revised its original
recommendation that dronedarone
(Multaq) should not be used to treat
atrial fibrillation (AF) – a disturbance
of the heart’s rhythm.
After considering comments on
the previous draft guidance, the
independent Appraisal Committee
decided to recommend limited use of
the drug as a second-line treatment in
people with additional cardiovascular
risk factors whose AF has not been
controlled by first-line therapy
(usually including beta-blockers).
Roche’s Xeloda (capecitabine) has
been approved by the European
Commission for post-surgery treatment
of patients with early colon cancer.
The drug is indicated in
combination with oxaliplatin – a
combined treatment named XELOX.
The XELOXA study, one of the
largest studies of early colon cancer,
showed that patients taking XELOX
immediately after surgery lived diseasefree for longer compared to those
treated with chemotherapy regimen
5-fluorouracil/leucovorin (5-FU/LV).
NHS pledges
to cut costs
The NHS has committed to
deliver £4.35bn of savings through
measures such as energy efficiency
and reducing staff sickness.
This will be the department’s
contribution towards the £11bn
savings that are being made across
Government by 2012–13, as
reaffirmed in the Budget 2010.
Novartis
vaccine EU
approved
EC approved
ACS
treatment
Novartis has received approval for
Menveo, the first quadrivalent conjugate vaccine in the EU to help prevent
meningococcal disease.
Menveo is indicated for the active
immunisation of adolescents (from
11 years of age) and adults at risk of
exposure to Neisseria meningitides
groups A, C, W135 and Y, to prevent
invasive disease.
approved Sanofi-aventis and BristolMyers Squibb’s dual antiplatelet combination tablet DuoPlavin/DuoCover
(clopidogrel and acetylsalicylic acid).
The combination treatment is
indicated for the prevention of atherothrombotic events in adult patients
already taking both clopidogrel and
acetylsalicylic acid (ASA).
NICE provides
clarity on pain
treatments
RA costs UK
£8bn each
year
NICE has published the first guideline
on the most effective drugs to treat
neuropathic pain in general and
community settings.
The new clinical guideline outlines
which drugs should be prescribed in nonspecialist settings and in what order these
treatments should be given.
Rheumatoid arthritis (RA) costs
the UK economy almost £8 billion
per year, yet NHS spending on the
condition is less than 9% of this figure.
These are the findings of a new
report, The Economic Burden of
Rheumatoid Arthritis, published by the
National Rheumatoid Arthritis Society
(NRAS) with support from Roche
Products.
Positive FAD
for Lilly’s
Alimta
Eli Lilly’s chemotherapy Alimta
(pemetrexed for injection) has
received a positive Final Appraisal
Determination from NICE.
The Institute recommends Alimta
as an option for the maintenance
treatment of people with locally
advanced or metastatic non-smallcell lung cancer with other than
predominantly squamous cell
(nonsquamous) histology, if the
disease has not progressed immediately
following first-line chemotherapy.
ABPI builds
Scottish team
The ABPI has appointed an Operations
Director in Scotland for the first time.
Sandra Auld joins the ABPI team
in Edinburgh from the NHS Scottish
Centre for Telehealth where she is
Service Development Manager.
Sandra Auld
Ailsa Bosworth
‘Perverse’
Vidaza ruling
appealed
Patient groups have appealed against
the negative recommendation by
NICE for the use of Vidaza (azacitidine) in patients with higherrisk
myelodysplastic syndrome (MDS).
Appeals have been lodged by MDS
UK, the Leukaemia Society and the
Rarer Cancers Forum.
Strong NHS
Q3 results
The NHS met a number of key
commitments on healthcare priorities
at the end of last year, the DH has
announced.
The Quarter 3 (October – December
2009) performance report highlights
that, despite the adverse weather
conditions, the NHS maintained its
commitment to treat all patients within
18 weeks from referral to treatment.
Commercial Skills
for the NHS
A definition of procurement in the context of commissioning healthcare has emerged
through the publication of a new DH document, which encourages NHS staff to improve
their commercial skills. Thoreya Swage reports.
T
he long awaited successor
to Necessity not Nicety has
finally been published after
a troubled gestation. Things seemed
to be progressing well until the
Secretary of State for Health, Andy
Burnham, mentioned in a speech to
the King’s Fund in September 2009
that the NHS would be the ‘preferred
provider’ in the provision of health
care, leaving the independent sector
apparently high and dry. This view
may have been influenced by the
health care unions, concerned at their
members losing out to non-NHS
providers, particularly in the current
economic climate.
The ‘preferred provider’ issue
came to a head when a PCT in the
Eastern region excluded non-NHS
providers in a procurement to run
its community services, triggering
an investigation by the NHS Cooperation and Competition Panel.
This, however, was stopped in February
by the Department of Health, possibly
indicating that this policy would not
stand up to legal scrutiny.
Furthemore, there were rumours
that members of the cabinet did
not share this view, leading to some
shuffling behind the scenes to allow
some flexibility in this approach. In
December 2009, NHS 2010–2015:
from good to great. Preventative, peoplecentred, productive was published,
seeking to clarify the situation
with regard to independent sector
involvement in health care. However,
the health economy had to wait for the
publication of Commercial Skills for the
NHS on 25th March 2010 to read the
finer rules of engagement.
The focus of the document is to
improve the commercial skills of NHS
staff and to support commissioners and
providers through access to specialist
commercial expertise at regional and
national level. Among the specific aims
such as using procurement to drive
service transformation, e.g. shifting care
for people with long-term conditions
from acute to community settings,
and developing the competence
of commissioners and providers in
undertaking clinical service reviews to
address performance issues, is a key
aspiration: “to continue to remove
potential barriers to the participation
of non-NHS providers”. Commercial
Skills claims to clarify ambiguities in
the predecessor document, Necessity
not Nicety and states that it reflects the
changing background in the NHS.
What is procurement in the
NHS?
The document defines what
procurement means in the context
of commissioning health care within
the NHS environment. It describes
how, over the last ten years, the
separation of commissioner/provider
roles has become clearer, with the
result that commercial processes
have come increasingly to the fore.
For services covered by existing
contracts, contract management is a
mechanism to drive improvements.
In contrast, procurement can be
used to create new contractual
relationships, whether with current
providers or new ones.
The document goes on to say that
procurement is a transparent process
of securing services to meet specific
commissioning needs, formally
engaging providers, resulting in a
contract. The matter of competition
between providers is regarded as
secondary. The revised Principles and
rules of cooperation and competition
guidance also published in March 2010,
explicitly says that commissioner or
patient choice should not be restricted
by agreements between commissioners
and providers.
The NHS Constitution states that
patients can expect choice of health care
regardless of which type of provider
delivers those services. Quality is
the basis for change in health care
and, to this end, the government is
asking the NHS and its staff to lead
this change together with partners
from other organisations. Commercial
Skills continues to repeat the policy of
allowing current NHS providers to have
two formal opportunities to improve if
underperforming, whilst, at the same
time, not ‘freezing out’ other possible
providers. The emphasis continues to
Pharmaceutical Field April 2010
be that of developing integrated care
across various boundaries and, if new
services are required, to look at what
the independent sector can provide.
Core principles have been set out for
commissioners, NHS providers and the
independent sector.
For commissioners, first and
foremost, it is essential that they
secure the best value for patients and
taxpayers. However, if services are to
be improved or developed, NHS and
other existing providers should be
involved at an early stage. If further
down the line the decision is made to
go to competitive tender, all providers
(NHS and non-NHS) should have
a ‘fair and equal’ opportunity to
bid. Underpinning such processes
are fairness, transparency and a clear
rationale for how the decisions are
made with oversight and assurance
through PCT Boards, the Department
of Health (DH) assurance of Strategic
Health Authorities (SHAs)and World
Class Commissioning.
For NHS providers, full involvement
of their staff is essential when
commissioners conduct service reviews,
particularly if there are concerns about
performance or addressing service
improvements. If new or substantially
redesigned services are needed,
engagement of current providers and
their staff is required at an early stage
so that they can contribute to service
specifications. If competition is used in
the service redesign process then NHS
providers should have an opportunity
to bid.
The document states that the
independent sector continues to
make a ‘valued contribution’ to
health care, specifically in adding
extra capacity, improving quality and
patient choice and driving innovative
practice. Where an independent
sector organisation is subject to
closer scrutiny on their performance,
they, like the NHS provider, will
have two opportunities to improve
their performance prior to contract
termination should no improvements
be forthcoming. As for the NHS
provider, if the route to improving
services is competitive tender then the
process is expected to be open, fair
and non-discriminatory.
All types of providers will have
a chance to highlight concerns or
complaints about competition and
procurement practices with the
commissioner, SHA and ultimately the
Co-operation and Competition Panel.
In situations where providers
are found to be failing, in addition
to working with the provider to
improve care, commissioners could
enlist the support of other providers
within the local health system. These
‘other providers’ could include the
independent sector.
Further details on procurement
can be found in the updated Primary
care trust procurement guide for health
services, published at the same time to
accompany Commercial Skills in the
NHS.
Developing commercial
skills in the NHS
The second aim of Commercial Skills in
the NHS is to support commissioners
and providers through access to
specialist commercial expertise. This is
a key area for struggling commissioners
who have been through the World
Class Commissioning assurance process
and have been found lacking in three
competences: effective stimulation
of the market, developing secure
procurement skills to manage contracts,
and managing systems and working
in partnership with providers. The
support also includes the improvement
of procurement skills of NHS provider
staff, e.g. responding to tenders,
costing and pricing and ensuring access
to information on commissioning
intentions and procurement activities
for all providers.
The specialist commercial expertise
comes in the guise of regionally based
commercial support units (CSUs)
which will be supporting both
commissioners and providers in their
area. Nationally, the NHS will continue
to strengthen its purchasing power by
preserving the NHS Purchasing and
Supply Agency’s (PASA) well regarded
secondary care pharmaceutical sourcing
activity long after the dissolution of
PASA itself at the end of March 2010.
Implications for pharma
Superficially it looks as though the
policy of engaging the independent
sector has not changed much since the
publication of the five year strategy
NHS 2010–2015. However, perhaps
the negative tone towards anything
non-NHS has been modified.
The way forward seems to be around
working with the NHS in delivering
and improving health care. The
emphasis on NHS staff, particularly
clinical professionals, leading service
improvement and redesign together
with partners is an important one, and
pharma should ensure that relationships
with these key personnel continue to be
developed and maintained, especially
if innovative ideas or evidence-based
practice are required. This could be an
opportunity to bring new initiatives
or different pathways of care from the
industry that have worked well in other
countries or health care systems.
The review of services as part of the
performance management process will
require clinical expertise which could be
supported by evidence-based practice
produced by pharma.
In terms of bidding for new services,
the fact that access to information
on commissioning intentions and
procurement activities will be
universally available will enable all
providers to have an equal opportunity
to prepare for tenders.
Removing the potential barrier of
excluding the independent sector in
tendering process through openness
and transparency will make it more
difficult for the NHS to award
contracts to preferred NHS providers
simply on the basis of their public
sector background.
A key role of the CSUs will be to
develop various strategic relationships
with non-NHS organisations in
order to widen the market for
commissioners. Here is an opportunity
to raise the profile of the pharma
industry in the area of new ideas and
innovative practice through such
contacts.
Whatever the forthcoming election
brings, it is clear that fair and open
competition for health care services
is here to stay and now is as good a
time as any to take advantage of this
climate.
Dr Thoreya Swage has several years’
experience in the NHS, both as
a clinician (psychiatry) and as a
senior manager, including Executive
Director for a Health Authority,
in various NHS organisations
covering acute and primary care.
She has expertise in commissioning
health services, most recently
working with the independent
sector as part of the Independent
Sector Treatment Programme at the
DH. She is currently working for
a number of NHS organisations,
including DH agencies, to develop
a more commercial approach to the
commissioning of healthcare.
MORE
PF 2010
features
online at
www.pharmafield.co.uk
New title, same job?
The psychology of KAM
Delivering the promise of Key Account Management requires a brave, cultural shift for
pharma. Letting go of the old approach is essential. Half measures will not suffice. Success
will come from embracing the concept fully, rather than simply rebadging traditional reps as
account managers. Adam Knights and Simon Toy assess the psychology of KAM.
I
f I place one foot in a bucket of
boiling water and the other foot
in a bucket of freezing water it
doesn’t take very long to work out
what a bad idea it was. It is certainly
not the same as plunging both feet in
a bucket at 50 degrees! What’s that got
to do with Key Account Management?
It means you cannot have a foot in
both camps, one in KAM and the
other in a traditional model. Real Key
Account Management is your biggest
opportunity and at the same time
your biggest threat. If you approach
your salesforce remodelling at the
half way house you will end up in a
world of pain, meaning that you will
have to change radically the culture in
the organisation in order to achieve
success.
Half hearted commitment can be
explained when we consider how
our thinking, in terms of our beliefs,
determine our motivation. Real,
sustained change only occurs when
two conditions exist:
approach, both of these conditions
do not exist. Whilst the benefits of
KAM (as outlined in this article)
appear very appealing and the
consequences of not making such
a switch very dangerous to the
business, there are the other, more
personal considerations.
1. The consequences of not
Firstly, what happens if the KAM
embracing change outweigh the
benefits of not making that change approach doesn’t work? If there is
a move to a more output rather
than an input focused reporting
AND
structure for KPIs, how will I know
who is working and who is not?
2. The benefits of embracing the
change outweigh the consequences How can I show that I am staying
on top of my sales force? How
of making the changes.
can I show cause and effect? How
can I manage under performance
Unfortunately, for many senior
without frequency and coverage
executives considering the
data?
wholehearted switch to a true KAM
Secondly, things are not all
bad at the moment anyway; at
least I have data to ‘prove’ who is
currently performing; I don’t want
to upset everybody by adding even
more change to an already rapidly
changing environment.
Most of these issues are very
personal to us as individuals, rather
than to our organisations.
The problem with the motivation
to change to KAM is simple:
1. We are being asked to give up
short-term benefits (it’s working
OK at the moment) at the risk
of long-term consequences (the
NHS is changing and we might
be left behind if we don’t change
with it).
AND
2. We must accept short term pain
(my salesforce will need reeducating, upskilling and in many
cases, a radical mindset shift)
with the potential of benefits in
the future (we will succeed in the
Brave New World, if it is, indeed,
a reality. After all, it might not be!)
Put in those terms it is hardly
surprising so many organisations only
half-heartedly embrace a true KAM
approach; BOTH of these conditions
must exist for committed change to
last.
The change to KAM is not easy
though; you have to start measuring
more outputs than inputs, assess your
business metrics, adapt your marketing
and throw away your coverage and
frequency model. You can’t claim to
have embraced KAM and then hit the
key account manager over the head
because of their low call rate. Look
at the duration of the call as opposed
to the number they have seen. What
would you like? Two calls a day at an
hour each or ten calls a day at two
minutes each?
One huge challenge with embracing
the KAM approach was summed up
recently by a senior pharmaceutical
sales manager we were dealing with:
“It’s not that our salesforce are not
sure how KAM differs from a more
traditional selling model, it’s that they
don’t believe that they are capable of
liaising at the more senior levels within
PCOs. They are too conditioned into
handing out pens and post-it pads,
believing that this is key to influencing
senior stakeholders. We need a serious
mindset shift in our salespeople in
order to really make KAM work. Most
programmes designed at delivering
KAM skills totally ignore this.”
Type ‘Key Account Management’
into Wikipedia and there is no
definition, which probably explains
why so many companies have their
own versions of it. Every time we
interview someone we ask them for
their individual definition. This can
range from “targeting customers more
effectively” to “understanding the
gatekeepers.” These are not wrong;
KAM however, does go a lot deeper.
We believe that real KAM involves
the process of proper customer
segmentation, whilst linking in the
current environment depending
on the PCO / account you may be
working. Real KAM needs a bottomup approach and accepts that some
areas are simply not worth working in;
you must be prepared to walk away
from difficult accounts that will drain
your resource for little return.
The single biggest contributor to
an effective KAM model is culture.
We can re-model saleforces as often
as we like, but if the culture does
behaviours, where wrong means
behaviours that everyone recognises as
not driving the business. How about
recognising innovative patient projects
and absolute growth for recognition
and reward? You will change the focus
in the company and the business will
understand what you are looking
for. A word of caution though, don’t
confuse ‘best practice’ with ‘standard
You can’t claim to have embraced KAM and
then hit the key account manager over the
head for their low call rate. Look at the
duration of the call, not the number of calls.
What would you like? Two calls a day at an
hour each or ten calls at two minutes each?
not change, it will not succeed. This
often means buy-in and changes
from the top to make this happen.
Successful companies that have moved
to KAM have included everyone in
the organisation. To change, culture
cannot simply be about the sales force;
it includes all head office personnel.
For example the Business Intelligence
Team may have different requests from
the field as the business starts to look
at and study different metrics; this in
turn puts more pressure in the system.
Some sales people have been
running their own region through
a KAM model for years, it’s just the
company didn’t see it. Many sales folk
have been at an appraisal and missed
out on an “A” because their call rate
wasn’t high enough, despite capturing
most new business with their “in
market” performance and delivering
on units and cash. We have all been
sat in the audience at conference and
seen the wrong people being pulled
up on stage for recognition as they
finished 120% of target and delivered
no new business; all that tells us is that
the target was wrong. Often underperformance gets recognised through
a variety of incentive schemes that
link tedious inputs to performance,
the result being that the salesforce
don’t “buy in” to the scheme and
start to resent it throughout the year.
The easiest way to de-motivate high
performers is to reward mediocrity,
or even worse, reward the wrong
practice’, running a big speaker
meeting that was ‘a great success’ is
not best practice unless you can throw
some dynamic metrics behind it.
Some of you will be reading this
article thinking to yourself “yes, this
is the exactly what we need to do
here”, but do nothing about it and
that’s because the cultural mind shift
to move to a KAM model is huge. It
takes all aspects of the organisation
to buy in and will mean people being
pulled from their comfort zone. Even
when we think something makes
sense and we say we want to embrace
change we often don’t. Why is that?
Simply put it can be summed up
in one word...fear. Fear can display
itself in many forms; loss of sales,
loss of control and fear of failure.
Ultimately, commitment to change
only occurs when we challenge the
beliefs we have that stop us from
taking action. Additionally, we need
to truly understand how our beliefs
motivate, or de-motivate us. This
means everyone in the organisation
not just acquiring the knowledge and
skills necessary to change to a KAM
approach, but also to develop the
winning attitude essential to making
that transition a successful one.
If you decide to make the move to
KAM, just go for it, don’t live in two
worlds, otherwise failure looms. The
process to make the full move is tough
and resistance will be strong, it will
also mean taking some casualties for
those that refuse or can’t understand it.
I met with a Sales Director friend
recently; he explained that the
company had made the successful
move to Key Account Management
over a year ago. That’s great, can you
validate it? The answers were quite
woolly and non specific. Asking
him to go back retrospectively and
study their promotional spend in the
field the year before, they went to
KAM and then studied spend for the
following year. Interestingly enough
the same promotional expenditure
was being spent on the same things as
the year before, by default they had
not made the move to Key Account
Management. All that had happened
was a re-badging exercise, what was
of concern is that the culture had not
moved on.
Like it or not, the current economic
world of cold climate will make you
change. There is no new money, new
products are facing vast market access
challenges and the NHS customer
has changed into a more commercial
and clinical animal. This is where the
opportunity now lies to do something
exceptional in pharma. Will you be
brave enough to embrace the whole
KAM concept or will you send your
team on a ubiquitous, generic KAM
course and just rebadge them?
Adam Knights is Managing
Director of 15Healthcare, which
acts as a healthcare broker between
the NHS and pharma through
holistic and strategic key account
management. Adam joined the
pharmaceutical industry in 1998
after a successful career in the
armed forces. He applied military
strategy and tactics early on to
develop an account model that
challenged traditional thinking
and planning. He went on to pilot
successfully the regional account
director (RAD) role in Takeda
before becoming the first RAD in
the UK and then sales director for
the RAD team. Simon Toy is the
Managing Director of Performance
Associates, a mindset and
behavioural change organisation
that works with numerous UK blue
–chip companies. Clients include
AstraZeneca, GSK, Solvay, 3M,
Meda Pharmaceuticals, Johnson
& Johnson, Lundbeck, Securicor,
Bristol-Myers Squibb, SkyePharma.
MAY 2010
Pharma can exploit political
uncertainty
The political uncertainty surrounding the UK’s first
coalition government since the second world war
could become a catalyst for progress with NHS/
industry joint working, a leading health figure has
said.
Mike Farrar, Chief Executive of North West SHA,
told a pre-election industry audience that if, together
with its NHS partners, it could present politicians
with carefully designed solutions rather than historic
problems, the opportunity for the two sectors to
work in partnership to regenerate the economy and
deliver benefits to patients and taxpayers was real.
May 2010
Do you need to
be better
eQIPPed? p14
Be prepared:
The Bribery Act
2010 p22
A glimpse of
coalition p18
Pharma can exploit
political uncertainty
The political uncertainty surrounding
the UK’s first coalition government
since the second world war could
become a catalyst for progress with
NHS/industry joint working, a leading
health figure has said.
Mike Farrar, Chief Executive of
North West SHA, told a pre-election
industry audience that if, together
with its NHS partners, it could present
politicians with carefully designed
solutions rather than historic problems,
the opportunity for the two sectors to
work in partnership to regenerate the
economy and deliver benefits to patients
and taxpayers was real.
Farrar said the industry needed
to take advantage of the political
uncertainty and to put itself in ‘a
good place’ to drive joint working
between pharma and the NHS, once
the situation was calmer. “We need to
put ourselves in a position where we
have policy we can place in front of
new health ministers to show that these
two sectors can
work together
for the good of
the country. We
need a policy
framework to
support us and
must be ready
for when that
landscape lands.”
Andrew Lansley
Andrew Lansley has been confirmed
as Secretary of State for Health and is
to form part of the new ConservativeLiberal Democrat coalition Cabinet
Lansley, who has been Shadow Health
Secretary since 2003, was one of the
five Tory health ministers to retain their
seats in the General Election, which saw
four key Labour DH members lose their
jobs. Health Secretary Andy Burnham
was the only member of the Labour
health team to keep his seat. Former
Health Ministers Ann Keen, Mike
O’Brien and Gillian Merron, as well as
ex-Care Services Minister Phil Hope, all
lost their seats to the Conservative Party.
The Conservatives and the Liberal
Democrats share some common
ground on health issues, though it
seems unlikely that there will be any
clarification on health policies until the
Queen’s Speech at the end of May.
The BMA has urged Lansley to
work with doctors in the formation of
new policy. “There is intense pressure
to make savings, but cutting clinical
staff or frontline services would be not
only shortsighted, but could also cause
irreparable damage to the NHS,” said
Dr Hamish Meldrum, Chairman of
Council at the BMA.
“Doctors will want to play a central
role in shaping the delivery of healthcare
and we would encourage the new
government to work with us to ensure
that this can happen.”
Lansley has previously pledged to
abolish ‘politically-motivated’ targets and
Mike Farrar told an ABPI audience that political
uncertainty was an opportunity for the NHS and
the industry to drive joint working
give greater autonomy to local clinicians.
Indeed, both coalition parties pledged
to cut bureaucracy and targets in their
manifestos.
However, there may be conflict over
the Conservatives’ plans to establish an
independent NHS board to run the
health service, as the Lib Dems have
advocated local health commissioning
boards.
The industry has reacted positively
to the news of the appointment. ABPI
Spokesperson Richard Ley told Pf:
“We are very much looking forward to
working with the new health team and
hope to have a meeting with them as
soon as possible.”
Court rules NHS prescribing incentives legal
The ABPI has lost its case that the NHS
is acting illegally in providing incentives
for doctors who prescribe cheaper
medicines.
The Association argued that such
incentive schemes were an illegal
inducement under European rules
on drug promotion. However, the
European Court of Justice ruled that the
prohibition did not apply to national
public health authorities that control
public funds, despite the fact that
individual doctors can profit from these
incentives.
The ABPI said: “The ABPI believes
it is important that patients can have
total confidence that when their
doctor is making prescribing decisions
those decisions are, and are seen to be,
completely independent of personal
financial considerations. The ECJ
interpretation of the legislation risks this
being put in doubt.”
The British Generic Manufacturers
Association (BGMA) has welcomed the
ruling. BGMA Director Warwick Smith
said: “We welcome the ECJ’s statement
that there are no patient health concerns
since all medicines are constantly
reviewed by the regulators.”
The ABPI will now consider the
implications of this decision on its case,
which is proceeding in the High Court.
PF-MAY10-NEWS.indd 1
Dolenio
launches in
the UK
Dolenio, the UK’s first licensed
glucosamine sulphate product for the
symptomatic treatment of mild to
moderate osteoarthritis of the knee, has
launched in the UK.
Traditionally, NSAIDS and other
analgesics have been the first-line treatment options for osteoarthritis chosen
by doctors.
Conditional
OK for Arzerra
Arzerra (ofatumumab) has received
a conditional European marketing
authorisation, providing a new option
for chronic lymphocytic leukaemia
(CLL) patients who have limited
treatment options.
(EMA) has granted this conditional
authorisation for the treatment of
CLL in patients who are refractory to
fludarabine and alemtuzumab.
13/05/2010 20:17
Crestor gains
new EU
indication
Court rules
incentives
legal
Priligy now
available in
UK
AstraZeneca’s statin Crestor
(rosuvastatin) has been approved in
nineteen countries within the EU for
the treatment of patients at high risk
of a cardiovascular event.
The drug is also indicated for the
treatment of high LDL cholesterol
(dyslipidaemia), total cholesterol
(hypercholesterolaemia) and/or
triglycerides (hypertriglyceridaemia).
The ABPI has lost its case that the
NHS is acting illegally in providing
incentives for doctors who prescribe
cheaper medicines.
The Association argued that such
incentive schemes were an illegal
inducement under European rules on
drug promotion. However, the European
Court of Justice ruled that the prohibition
did not apply to national public health
authorities that control public funds,
despite the fact that individual doctors
can profit from these incentives.
The first prescription treatment for
premature ejaculation is now available
to men in the UK through an online
consultation service.
Although not licensed in the UK,
Priligy, manufactured by Janssen-Cilag,
can be accessed online through a unique
service provided by Lloydspharmacy.
Counterfeits
targeted by
MEPs
Pfizer cancels
Sutent trials
Pfizer has discontinued its Phase III
study of Sutent (sunitinib malate) in
advanced hepatocellular carcinoma
(HCC), or liver cancer.
Following a review by the
independent Data Monitoring
Committee (DMC), the study was
discontinued based on a higher incidence
of serious adverse events in the sunitinib
arm compared to the sorafenib arm.
Proposals to crack down on counterfeit
medicines were approved by the
Environment, Public Health and Food
Safety Committee of the European
Parliament this month.
The recommendations, which include
the covering of internet sales in draft
EU legislation to prevent fake medicines
from entering legal supply chains and
measures to improve pharmacovigilance,
were proposed by the European
Commission in December 2008.
Humira to
top charts
The rheumatoid arthritis treatment
Humira will replace Lipitor as the
world’s biggest-selling drug in 2016, but
Pfizer will still hold the highest medicine
sales, latest industry predictions state.
The World Preview 2016 report,
published by EvaluatePharma,
contradicts previous estimates that
cancer treatment Avastin would
emerge as the biggest blockbuster drug
following Lipitor’s patent expiry. Due
to some clinical setbacks for Avastin,
EvaluatePharma now forecasts Humira
to be the top drug with sales of $10.1bn
in 2016.
HAVE YOUR SAY
EC approves
low-cost
hepatitis C
treatment
Biopartners has secured an EU
marketing authorisation for its
biosimilar version of branded drug
Rebetol.
approved Ribavirin Biopartners
200mg film-coated tablets.
MAY 2010
Indication
extension for
Tarceva
‘Heartless’
New treatments
SMC decision approved for
on cancer
NHS Scotland
ABPI
appoints
Catchpole
Tarceva (erlotinib) will soon be available to
more EU patients with advanced non-small-cell
lung cancer (NSCLC), following its approval as
a first-line maintenance treatment in this setting.
The European Commission has extended
its indication to include monotherapy
maintenance treatment in patients whose
disease remains largely unchanged (stable
disease) after platinum-based initial
chemotherapy.
The Scottish Medicines Consortium
(SMC) has ruled against a drug
that could be used as a second-line
treatment against kidney cancer.
The SMC did not accept Afinitor
(everolimus) for the treatment
of patients with advanced renal
cell carcinoma whose disease has
progressed in spite of vascular
endothelial growth factor (VGEF)targeted therapy.
The ABPI has appointed Paul
Catchpole into the role of Director of
Value and Access.
In his new role, Paul will drive
forward the ABPI’s work to
demonstrate the value of the industry
and its medicines, and to improve
access for patients to innovative
medicines. He will be based at the
ABPI’s offices in Whitehall.
Diovan
approved for
children
The world’s number one selling high
blood pressure medication is now
available for children in the EU.
granted Novartis’ Diovan (valsartan)
a new paediatric indication for the
treatment of hypertension in children
and adolescents 6–18 years of age.
New class of
COPD
treatment
The only once-a-day oral tablet for
the treatment of Chronic Obstructive
Pulmonary Disease (COPD) has been
recommended for use in the EU.
If it is approved by the European
Commision, Nycomed’s antiinflammatory therapy Daxas (roflumilast)
will become the first new class of treatment
for COPD in more than a decade.
Epicept launches
Drug offers
leukaemia
new approach treatment
The first fixed-dose combination
therapy for benign prostatic hyperplasia
(enlarged prostate) has received a UK
license.
Combodart (dutasteride/tamsulosin
hydrochloride) is a new, once-daily
combined treatment that can relieve
symptoms and prevent disease
progression in this common condition.
EpiCept Corporation has launched
its leukaemia drug Ceplene
(histamine dihydrochloride) in the
UK.
The drug’s launch was timed to
coincide with the British Society
for Haematology 50th Annual
Scientific Meeting in Edinburgh.
Abraxane (paclitaxel albumin) will be available
for restricted use within the NHS in Scotland,
following a positive opinion from the SMC.
The drug has been approved for the
treatment of metastatic breast cancer in
patients who have failed first-line treatment
for metastatic disease and for whom standard
anthracycline-containing therapy is not
indicated.
Cephalon
completes
Mepha deal
Swiss-based pharma company Mepha
has become a wholly-owned subsidiary
of Cephalon, following its acquisition
by the larger company in a deal worth
approximately US$615.4 million.
Branded and non-branded generics
manufacturer Mepha is the leading
company in the Swiss generic market,
with more than 120 products.
NICE to
consider
Avastin
NICE is considering recommending
Avastin to treat wet age-related macular
degeneration, even though it is not
currently licensed in this indication.
Lucentis is the drug currently
recommended for use by NICE, but
it is an expensive treatment and was
originally derived from the cheaper
cancer drug Avastin.
Paul Catchpole
New CEO
for Bayer
HealthCare
Dr Jörg Reinhardt is to be the new
head of Bayer’s HealthCare division,
effective from August this year.
The 54-year-old previously worked
as Chief Operating Officer of Novartis
AG.
Sanofi-aventis
executive leaves
company
Laurence Debroux, Senior Vice
President, Chief Strategic Officer and
member of the Executive Committee
at sanofi-aventis, will be leaving the
company as of July 2010.
Debroux was appointed to her
current role in February 2009. Sanofiaventis has announced that she will be
moving to “pursue another professional
challenge”, but has yet to announce her
successor.
Looking back and
looking forward:
ABPI launches Annual Report and plans for 2010
T
he ABPI has promised that
in 2010 the UK will start to
move into a position of world
leadership in creating, valuing and
accessing healthcare innovation.
Its recently launched 2010 Strategic
Plan includes promises to boost trust
in the industry, extend and improve
joint working between companies
and the NHS and build on the
momentum started by the Office for
Life Sciences.
The ABPI has also published its
2009/10 Annual Report, which cites
the Kennedy Report and its attempts
to reform Healthcare Technology
Assessments (HTA), as well the
introduction of the OLS, as major
achievements of the past 12 months.
Looking back
The Annual Report looks back on
what is described as “an eventful and
successful” year and is optimistic about
the industry’s future, but points out
that the “financial and NHS climate”
must be “conducive to innovation”.
The Report states: “The
opportunities that lie ahead for the
UK pharmaceutical and biotechnology
industry in a globally dynamic
environment are vast. The fast moving
pace of science, if harnessed, will enable
the UK to retain its position as a world
leader in the life sciences industry.”
Last year saw the launch of the
ABPI’s four key imperatives: Value,
Innovation, Trust and Access, or
VITA, which have been the focus of
its activities. Achievements are targeted
within these areas and separated
within the document to illustrate this
structure.
However, in terms of overall
achievements, the document focuses
mainly on the ABPI’s improved
relationship with healthcare providers
and regulatory authorities, in particular
through the progress achieved by the
launch of the Office for Life Sciences.
A key achievement for the industry
was the establishment of the Office
for Life Sciences, which recognised
that joined-up government action was
required to protect the interests of the
life sciences industry in the UK.
As a result of collaboration between
the ABPI and the Office for Life
Sciences, the Life Sciences Blueprint
was published in July 2009 and Life
Sciences 2010: Delivering the Blueprint
in January 2010. These encompassed
vital initiatives, including the Patent
Box, the Innovation Pass and the Life
Sciences Super Cluster, each of which
considerably improved conditions and
incentives for life sciences companies
operating in the UK.
Other achievements for the ABPI
over the last year include:
• The Kennedy report including
recommendations that will enable
companies to have increased
involvement in the Health
Technology Assessment (HTA)
process.
• Continued collaboration between
the ABPI and NHS Chief
Executive David Nicholson on
how the industry can support the
QIPP agenda.
ABPI objectives
•
•
•
•
•
•
•
To maintain the UK’s position
as a leader in the global
pharmaceutical industry
To enable the pharma industry
to be a trusted partner in the
delivery of healthcare
To make the ABPI the
acknowledged authority on the
pharmaceutical industry with
key stakeholders
A commitment to R&D being
added to the Annual Operating
Framework for the NHS.
The NHS Constitution enshrining
the right of patients to have access
to NICE approved treatments.
The success of industry-NHS joint
working projects.
The creation of a forum to allow
industry to engage with Higher
Education institutions to enhance
the skills needed by the industry.
Pharmaceutical Field May 2010
“The ABPI is a catalyst for a new era of innovation
in pharmaceuticals, improving the health and
wealth of the nation. In the next decade, the
UK will move to a position of world leadership
in creating, valuing and accessing healthcare
innovation... We are looking forward to working
even closer with all our stakeholders in the new
political environment to achieve this”
Beyond sponsorship
One key theme of this year’s Annual
Report is the potential for joint
working between the health service
and the pharma industry and the
document focuses particularly on
achievements in this area.
These include the start of the
ABPI’s NHS Partnership Programme
to allow closer engagements between
companies and the NHS, and launch
of the Moving Beyond Sponsorship
joint working toolkit in March 2008.
“This commitment to a
shared vision and a more mature
relationship between pharmaceutical
companies and NHS organisations
has already proved it can deliver
better patient care,” the Annual
Report states.
A new era
The 2010 Strategic Plan begins by
describing the ABPI as offering a
“compelling single voice founded on
a shared understanding”.
It goes on to say: “The ABPI is a
catalyst for a new era of innovation
in pharmaceuticals, improving the
health and wealth of the nation. In
the next decade, the UK will move
to a position of world leadership
in creating, valuing and accessing
healthcare innovation.”
The Plan divides the ABPI’s key
campaign objectives for the coming
year in accordance with the four
VITA imperatives. The campaign
objectives will be:
•
Key messages for 2010
•
•
•
The ABPI is the globally
respected voice of the UK
pharmaceutical industry,
which is world leading in the
discovery and development of
vital new medicines.
The UK pharmaceutical
industry is one of the most
valuable industries in the UK
and is part of the solution for
delivering better outcomes for
patients, the NHS and the
UK economy.
The ABPI believes that UK
patients should have access
to appropriate, innovative
medicines, ensuring that the
right patient receives the right
medicines at the right time
•
•
•
•
To ensure innovative
medicines are valued in the
UK as cost-effective solutions
for preventing and treating
diseases (Value).
To restore the UK as a world
class leader in innovation by
fostering excellence through
key stakeholder partnerships
(Innovation).
To create a new contract
between industry and society
based on integrity, honesty,
knowledge, appropriate
behavior, transparency,
openness and trust (Trust).
To get the right medicine to
the right patient at the right
time (Access).
The document also contains
the ABPI’s top level organisational
objectives and how these will
translate into activity for each of the
imperatives.
The first of these is to maintain the
momentum started by the launch
of the Office for Life Sciences, and
is associated with activities such as
implementing the Innovation Pass,
leveraging the QIPP opportunity,
expanding joint working to a national
scale, launching the Super Cluster
and creating a positive environment
for early clinical research.
The ABPI’s second objective is
to secure commitment to HTA
reform to ensure that the UK is
an environment that champions
innovation, which will include the
publishing of guidance for companies
on data collection for HTAs and the
launch of a Blue Print document
describing how the UK can become a
global centre of excellence in this area.
The Association has also committed
to implementing various behavior
changes to boost the trust between
the ABPI and other bodies, including
new proposals within the Code of
Practice to promote transparency,
an annual survey conducted with
stakeholders to gauge the reputation
of the industry and a position paper
on best practice in research data
sharing to be delivered to the EFPIA
by the end of 2010.
Further objectives for 2010
are to agree principles for future
PPRS, improve smaller member
engagement, resolve pension
conflict and agree ABPI financing,
modernise ABPI systems and
facilities and to bring life science
trade associations together.
In conclusion
The Annual Report concludes:
“Great progress was made in
working towards improved health
outcomes for patients, working
in collaboration with the NHS
and creating a better investment
environment for our industry.
However, we still need to do more
to ensure that all patients in the
UK have access to new medicines
and treatment with no geographical
anomalies, delay or restrictions. We
are looking forward to working even
closer with all our stakeholders in
the new political environment to
achieve this.”
The 2009/10 Annual Report and
2010 Strategic Plan are available at
http://www.abpi.org.uk/recent.asp.
MORE
PF 2010
features
online at
www.pharmafield.co.uk
A glimpse of coalition
Pf Editor Chris Ross reports on an annual ABPI conference coloured by pre-election fever
and driven by a determination for industry and NHS to work together for the good of the
nation. But will the wider industry be able to build on its manifesto pledges?
T
he spectre of an imminent
General Election loomed
large over the 2010 ABPI
Conference, which took place ten
days prior to polling day. Proceedings
became a strange portent for the
post-election political discussions
that would later emerge, centring as
they did on the need for two parties
to work together in partnership for
the greater good. A full working
coalition between the NHS and the
pharmaceutical industry has, until
now, appeared as likely as a Liberal
Democrat sitting at the top table of
government. But in this figurative
time for change, joint working is now
considered ‘in the national interest’
– and the ABPI conference addressed
it with relish. Unlike political
coalition, however, the collaboration
between NHS and industry cannot be
considered as a temporary measure.
It must, the conference concluded,
become a long-term commitment.
Unlike the 2010 General Election,
the ABPI Conference managed to
deliver an overwhelming majority
– with presenters and audience
members alike united in the view
that the old adversarial pharma/NHS
relationship is ‘old politics’, and that
joint working represents the future
for both parties. Political rhetoric? It
cannot afford to be. The experts claim
partnership working is an obligation
not an option. Me? Well, to use some
recent political vernacular, “I agree
with Nick.”
ABPI Director-General, Richard
Barker, told delegates that partnering
with the NHS was the biggest issue
facing industry at the moment.
The agenda, he said, had been put
together to help debate solutions to a
range of challenges:
• How can we partner to bring
•
•
•
new medicines to market via UK
research and clinical trials?
How can we evaluate them more
broadly and more fairly across
the UK?
How can we provide patient
access to the best available
treatments?
How can we work together
with NHS management and
NHS professionals to reduce the
burden of disease?
Within the auditorium, conformity
with these principles and objectives
was widespread – but as with many
such conferences, it is often the
audience outside of the room that
matters most. Persuading the nonbelievers of the need for change will
remain the biggest challenge.
Barker said the industry’s
relationship with the NHS was now
entering a third phase. The first phase
has previously been described as
‘trench warfare’, whereby the industry
sought to promote its products and
the NHS sought somehow to avoid
it. “The second phase, which I’m
delighted to say is where we have been
for a few years now, is in experiments
in joint working,” said Barker. “We’ve
got more than a dozen of these
experiments going across the UK and
some of them have got to the point
in their lives where we’ve been able to
demonstrate real impact in what they
achieve on the burden of disease. But
I’d like to see us move to a third phase
of relationship with the NHS, which
is partnering to address each other’s
challenges.”
The challenges facing the NHS
are well-documented and have been
further highlighted by the glare
of publicity the General Election
has provided. The UK’s desperate
economic climate has driven an
annual funding gap of between
£15-20 billion by the end of the next
planning period. To help achieve it,
the QIPP agenda, is crucial – and
joint working is seen as a significant
component in delivering success.
The financial drivers for progressing
joint working were further outlined
by Mike Farrar, Chief Executive,
North West SHA. Farrar said that the
business case for working together
more effectively had never been more
compelling in terms of the patient,
the taxpayer and the economy. “If we
can get our act together and add value
to what we do, we can really help
transform the state of the economy.
It behoves us to find a better way to
work together than perhaps we have
done in the past. We can’t afford to do
what we’ve always done,” he said.
Pharma and QIPP
The need to change behaviours was
a resonant theme of the conference,
but Farrar warned that old behaviours
and perceptions are stubborn and
difficult to shift. Progress, he said,
would require both parties finding
a common language. “The language
we talk about constantly is the QIPP
challenge – Quality, Innovation,
Productivity and Prevention. And
the pharmaceutical industry can help
us meet this challenge.” Outlining
the four pillars of the agenda, Farrar
pinpointed where the industry can
play a part:
• Quality – the pharmaceutical
input into the quality of patient
care is significant, not only in
terms of new products, but also
existing products. The challenge
is to ensure patients get swifter
access to them and are supported
in terms of compliance to make
sure we get the benefits. “We also
need to make sure our services
are aligned to them, so that we
have a whole service offer not just
a single product offer.”
• Innovation – the creation
of the Life Sciences Delivery
Board is an opportunity to
bring sectors together – NHS,
industry, academia. “This makes
sense in terms of aligning
businesses, getting businessto-business relationships and
adding value to the processes we
share. Innovation will be a clear
manifestation that we are getting
this right. Waste often occurs
in industry business processes
because the health service hasn’t
specified what it wants properly.
By sharing the pipeline earlier,
building business processes so
that as the NHS goes through
selection of those products it can
actually be prepared for their
entry, we will deliver value and
get products used sooner.”
• Productivity – executives across
the industry will be sitting on
information where they know
that if the pharmaceutical inputs
can be got right in terms of
the care pathway, NHS and
associated care staff would be
much more productive. In the
process, lengths of hospital
stays will reduce, the number of
operations will increase and more
opportunities to care for people
within the existing inputs that
we’ve got will emerge.
• Prevention – this is not only
relevant to the NHS, but also to
every single country whose health
service costs have increased due
to the extra demand driven by
the ageing population and new
technologies. The demand side
of the equation has not yet been
managed.
Top left: Richard Barker, Top right: Mike Dixon, Bottom left: R Blackburn, Botton right: Patrick Hopkinson
“In all these dimensions, the
industry can help me achieve these
challenges,” said Farrar. “In return,
I can offer value back and allow you
to avoid the waste and get higher
returns. But if we know what we
should be doing, the question we
have to ask ourselves is why we are
not translating that into action. This
is a world that has been completely
stubborn to a lot of senior leadership
cajoling. It makes absolute business
sense for us to try to work on this
agenda. But if that’s the view from
the top of the office, why are we
not able to get it into place? We
need to get this drilled down into
our organisations so that at middle
management level we’ve got the
right behaviours, the right degree of
honesty and trust, the right amount
of confidence and courage to work
with each other in a different way.
That’s the journey.”
Farrar said that the journey called
for new skillsets and increased
emphasis on training. “How do
people making the decisions get
trained? How do they understand
the nature of the business when they
look at it from the industry or on the
NHS side? How do we understand
and walk in each other’s shoes? That’s
where we have got to put attention
and energy.”
Industry perspectives
From an industry perspective, the
view from the top was similarly
positive. Senior figures from some
of the industry’s largest companies
presented examples of their
experiences in joint working and,
in the process, became powerful
advocates of the opportunity
to partner. Patrick Hopkinson,
Director, Portfolio and Partnership
Marketing, GSK said: “This is an
incredible opportunity to bring
together great people, resources and
skills for the benefits of patients.
Partnership working can transform
the relationship the industry has with
the NHS, but it needs to be more
than a nice sentiment, it needs to be a
strategic imperative.”
Alan Barge, VP and Head of
Oncology and Infection TA,
AstraZeneca, said that all the
ingredients for success were there,
and that the industry could provide
the glue to hold it all together.
Using alcohol as a metaphor, he
said: “Between us, in academia, the
NHS and the industry, we have a
full six-pack. We have everything we
need to develop innovative, groundbreaking treatments for cancer, to
deliver them to patients and to make
them cost-effective. But somehow,
it sometimes seems we are missing
the plastic ‘thingemy’ that holds it
all together. My vision is to be the
plastic thingemy, so that ultimately
we have a full six-pack that holds
together. In the UK, we have all of
the components. Our challenge is to
make it happen.”
Healing the relationship
One of the biggest challenges,
however, is to improve trust in
the industry. Richard Blackburn,
Managing Director, Pfizer UK,
said that there are varying levels of
trust between different parts of the
NHS and the industry, but that
improving this was a major objective.
He presented a slide that included a
sticker one of his colleagues had seen
on the door of a medical school. The
sticker encouraged students to ‘say no’
to drug reps.
“This is the sort of thing you
normally see associated with stopping
smoking or internet predatory. Can
it really be the view that our future
prescribers have of the people they
meet from our industry? I don’t think
it is representative, but it does serve
The ABPI should change its code of practice to bring
an end to the practice of industry representatives
giving gifts to doctors and their support staff. Acting
on this single recommendation alone would do much
to rebalance the relationship between medicine and
industry.” Royal College of Physicians, 2009
to remind us that there is a problem
that we cannot afford to ignore.”
Blackburn highlighted a handful
of initiatives designed to tackle the
issue of trust, outputs from the ABPI
Trust Imperative Board. Promotional
items were cited as a negative force.
“The ubiquitous pens, pads and
other giveaways have become a
stick that our industry critics beat
us with. They represent the kind
of relationship where we hope that
the significant value that we bring
to our customers will somehow
be remembered as a result of the
relatively cheap item we have left
with them. The time has come for
us to put an end to that practice.
Until we do, it is just going to be
something that gets in the way of us
moving forward.”
Blackburn drew attention to
the words of the Royal College of
Physicians to support the argument:
“The ABPI should change its Code
of Practice to bring an end to the
practice of industry representatives
giving gifts to doctors and their
support staff. Acting on this single
recommendation alone would do
much to rebalance the relationship
between medicine and industry.” In
November, ABPI member companies
will have the opportunity to vote on
a proposal to do just that. Another
vote will be taken on a proposal to
declare publically all payments made
by pharma companies to HCPs. The
ABPI will also encourage further
dialogue around the funding of
medical education, meetings and
training. This, said Blackburn, was
a legitimate debate that encouraged
divergent views. The overall aim,
he said, was to improve what had
become a dysfunctional relationship
between NHS and pharma.
“Industry is honestly trying to
address that. My plea would be that
our colleagues in the NHS see that
and respond to it.”
Clinical leadership
One senior NHS figure, Mike
Dixon, Chairman of the NHS
Alliance, said that he was impressed
by the ABPI’s desire to make joint
working happen, rather than allow it
to become a ‘hollow desire because
it sounds like a good idea.’ Dixon
apologised on behalf of fellow
clinicians, who he said had been
complicit in a plot that had led to
a mistrust of pharma. But Dixon
raised the concern that much of the
dialogue promoting the benefits
of joint working was taking place
between industry and ‘NHS
managers’. “This conference has
talked about working with leaders,
and all the leaders are managers. I
hope in the new world that we will
see clinical leadership take a more
central role in how the health service
is working,” he said. “It doesn’t make
sense to have the managers managing
and the clinicians spending their
money. The two need to meet
up just as the industry and NHS
needs to. In this new world, the old
world of SHAs, PCTs and practices
are going to give way and clinical
leadership will emerge as being
more important. Localism will be
important, and groups of practices
forming to provide and commission
will increasingly be clinically led and
an important point of contact for the
industry. I think you need to prepare
for that.”
The ABPI Conference took
place in central London at the
impressive conference venue, The
Brewery. Dixon took Alan Barge’s
alcohol metaphor to new levels,
mischievously commenting that the
venue selection had been designed
to show that the ABPI could indeed
produce a good piss-up in a brewery!
The mood of the meeting was, of
course, more serious as delegates
consumed the challenges of the
political and economic environment
that faced them. But the conference
dinner that followed proceedings
did allow for some champagne
celebration – not least for the two
projects that were awarded the very
first ABPI Joint Working Awards (see
news on p3). Further information
on these, and other, joint working
projects will be published in HSP’s
new publication, Partnership in
Practice, later this year.
The ABPI Conference 2010 was held at The Brewery, London a week before the general election.
20
JUNE 2010
Patient-centric health policy
branded ‘idiocy’
New Government proposals to
penalise hospitals for readmissions
have been branded as ‘idiocy’ by
surgeons.
The policy, outlined in Andrew
Lansley’s first significant speech
since becoming Health Secretary,
will make hospitals responsible for
patients for 30 days after they have
been discharged, and deny them
additional payment for treatment
upon readmission.
NICE
recommends
Xeloda
NICE has recommended that a new
convenient treatment for advanced
gastric cancer be made available to
NHS patients.
Roche’s Xeloda (capecitabine)
has been given the go-ahead in
combination with a platinum-based
regimen for the first-line treatment of
inoperable advanced gastric cancer.
Nexavar too
costly for
NICE
NICE has said it is unable to
recommend Nexavar (sorafenib)
for treating advanced hepatocellular
carcinoma (HCC) due to its high cost
and limited benefit.
NICE’s final guidance is that the
drug should not be funded by the
NHS, despite an appeal and proposals
to implement a patient access scheme
by the manufacturer, Bayer.
Power
to the
people p16
Pharma market
access: a midterm report p18
June 2010
KAM: How
do you
measure up? p23
Patient-centric health
policy branded ‘idiocy’
New Government proposals to
penalise hospitals for readmissions
have been branded as ‘idiocy’ by
surgeons.
The policy, outlined in Andrew
Lansley’s first significant speech
since becoming Health Secretary,
will make hospitals responsible for
patients for 30 days after they have
been discharged, and deny them
additional payment for treatment
upon readmission.
Lansley says the policy encourages
hospitals to focus on successful initial
treatment. But the Association of
Surgeons of Great Britain and Ireland
said it would mean day surgery
patients would be kept in overnight at
extra cost and labelled it as ‘shortsighted and counter-productive’.
Vice-president Professor John MacFie
said: “It will encourage hospitals to
keep patients in. The policy is idiocy.”
Lansley said the NHS is not
just paying for activity, but for
‘performance and results’: “The
outcome for the patients is the only
outcome that matters – and so we
are sending a clear message to the
NHS that patient care doesn’t end
when they walk out of the hospital
door. This will have the added benefit
of driving the further integration
of hospital and community services
where it most matters. Patients don’t
PF-JUNE10-NEWS.indd 1
talk about ‘primary’ and ‘secondary’
care, they see it simply as treatment
and care for the problem they have,
whether at home or in hospital.”
Lansley’s plans to build a patientcentred NHS were presented at
a health centre in East London.
There would, he said, be no “tradeoff between safety and efficiency”.
“Good care is safe care. Unsafe
care costs more, in lives and cash.
High levels of infection, CTE,
emergency readmissions, falls,
pressure sores – all lead to more
suffering and more cost,” he said. “I
will not countenance a ‘production
line’ approach to healthcare which
measures the volume but ignores the
quality.”
Lansley promised an information
revolution across the NHS, saying
that patients need to know who
is providing quality, safe, effective
and accessible services. “It’s not just
about choice. The combination of
information and choice will hold
people to account and drive up
standards.”
Dr Anna Dixon, Director of Policy
at The King’s Fund, backed the plans.
But, despite Lansley’s insistence that
“this isn’t about money, it’s about
raising standards and quality”, Dixon
said the real challenge was how
to secure these gains while facing
increasing financial constraints.
“These proposals could offer an
opportunity to drive quality in the
Andrew Lansley
NHS by ensuring that hospitals are
incentivised to provide good-quality
care, but the key to the success of this
policy will be to ensure sufficient care
can be provided in the community
following a patient’s discharge,” she
said. “This will require hospitals
to work with primary care and
community health care providers to
ensure that services are in place for
patients on discharge and that they
are not kept in beds for longer than
necessary.”
NICE rejects Tyverb despite patient access scheme
Government plans to review NICE and
set up a cancer drugs fund have been
brought into immediate focus following
the watchdog’s latest rejection of a
cancer treatment.
Draft NICE guidance has concluded
that GSK’s Tyverb (lapatinib) will not
be recommended for use on the NHS
for breast cancer.
Tyverb was assessed in combination
with capecitabine (Xeloda) for women
with advanced or metastatic HER2positive breast cancer, but it was ruled
that it should only be used in the
context of clinical trials.
GSK had set up a patient access
scheme under which it would pay for
the first 12 weeks of treatment, but
despite this, NICE said the drug does
not provide sufficient clinical benefit to
justify its cost.
GSK has responded by saying that
there are no other licensed ErbB2
targeted treatment options available to
suppress the advanced disease and that
many receive Herceptin (trastuzumab)
off-licence. Simon Jose, General
Manager, GSK UK, said: “This again
highlights the limitations of the NICE
appraisal process when evaluating cancer
treatments for patients facing a relatively
short life expectancy.
(Continued on p5)
16/06/2010 13:25
NICE rejects
Tyverb
Government plans to review NICE
and set up a cancer drugs fund have
been brought into immediate focus
following the watchdog’s latest rejection
of a cancer treatment.
Draft NICE guidance has concluded
that GSK’s Tyverb (lapatinib) will not
be recommended for use on the NHS
for breast cancer.
WHO denies
industry
influence
WHO’s Director-General has denied
that the organisation’s decisions
over swine flu were influenced by
commercial considerations.
Reports in the BMJ and elsewhere
had accused WHO of being led by
the pharma industry to exaggerate
the potential impact of the
pandemic.
HAVE YOUR SAY
Multiple
myeloma
treatments
Thalidomide and Velcade (bortezomib)
improve the effectiveness of current
treatments for multiple myeloma,
NICE has concluded.
The two medicines have been
recommended in draft guidance, in
combination with an alkylating agent
and a corticosteroid, in patients for
whom high-dose chemotherapy with
stem cell transplantation is considered
inappropriate.
Prix Galien
finalists revealed
Medicines from some of the
pharmaceutical industry’s leading
players will compete for two prestigious
UK Prix Galien medals at the House of
Lords this October, after the shortlist of
finalists was revealed.
The 2010 awards, billed as the
‘Nobel Prize for drug discovery’ by
head judge, Professor Sir Michael
Rawlins – Chairman of NICE –
will see treatments from across the
therapeutic spectrum battle it out for
Prix Galien recognition.
UK launch
for innovative
treatment
Lung cancer
drug approved
NICE has issued draft guidance
recommending Iressa (gefitinib) as
an option for the first-line treatment
of people with locally advanced or
metastatic non-small-cell lung cancer.
Patients will qualify to receive the
treatment if they test positive for the
epidermal growth factor receptor
tyrosine kinase (EGFR-TK) mutation.
A first-in-class biological for the
treatment of osteoporosis has been
granted marketing authorisation in
the UK.
Prolia (denosumab), which is
indicated to treat post-menopausal
women, has been shown to reduce
fractures by up to 68% and can be
given as six-monthly injections in a
GP surgery.
Follow Pf on
Twitter
@PharmaField
Specialists appeal over Vidaza
Thirty-two international MDS Centres
of Excellence have written to the
National Cancer Director to support
better access to Vidaza (azacitidine) for
UK patients.
International haematologists and
cancer specialists from the hospitals
expressed their concern at the NICE
decision not to recommend Vidaza
for the treatment of myelodysplastic
syndromes (MDS), a group of
debilitating bone marrow diseases.
Campaigners outside No.10
JUNE 2010
New draft
Innovation
Novartis staff
Government
awarded millions guidance on
could impose cost leader joins
arthritis drugs controls
ABPI
A jury found Novartis guilty of
discriminating against 12 female
representatives and entry-level
managers over pay, promotions and
maternity leave in a Manhattan federal
court earlier this week. An initial $3.3
million was awarded to the women.
The punitive damages to be paid
by Novartis are higher than analysts
predicted and represent 2.6% of the
company’s $9.5 billion 2009 revenue.
Three treatments for psoriatic
arthritis have been recommended in
final draft guidance by NICE.
Etanercept (Enbrel), infliximab
(Remicade) and adalimumab
(Humira) were assessed for treating
adults with active and progressive
psoriatic arthritis when specified
criteria are met.
The Coalition Government’s plans
to introduce ‘value-based pricing’ for
medicines could mean that price controls
will be imposed.
Industry analysts predict that the UK
could soon lose its position as one of the
few markets in the world where pharma
is free to set the price of its products.
New options
available for
Crohn’s
New guideline
to benefit LUTS
sufferers
NICE has recommended two new
treatment options for people with
severe Crohn’s disease.
The guidance approves the use of
Remicade (infliximab) and Humira
(adalimumab) for adults with a severe,
active form of the disease. Infliximab
is also recommended for adults with
active, fistulising Crohn’s disease, and
for children and young people aged
6–17 years old with severe, active
Crohn’s disease.
NICE has issued the first national
guidance on the diagnosis and
treatment of men with urine problems.
The new guideline aims to set a
national standard so that all patients
receive the same quality of treatment
wherever they go.
Revolade
rejected for
ITP
NICE has ruled that there is insufficient
evidence to recommend GSK’s Revolade
(eltrombopag) for the treatment
of chronic immune (idiopathic)
thrombocytopenic purpura (ITP).
Preliminary guidance states that
the drug is not recommended for ITP
in splenectomised adults who do not
respond to other treatments (for example,
corticosteroids, immunoglobulins),
or as second-line treatment for nonsplenectomised adults when surgery is
not advised.
Xolair offers
‘limited benefits’
NICE has decided that Xolair
(omalizumab) does not represent good
value for money for the treatment of
severe persistent allergic asthma in
children aged 6-11 years.
As a result, NICE has issued
preliminary guidance recommending
that the drug is not funded by the
NHS for this patient group. The
Institute also concluded that the drug
would only be suitable for around 300
patients in the UK.
Carol Blount
New diabetes
New chairman tablet
launched
at BGMA
Michael Cann, Director Generics at
Actavis, has taken over as Chairman
of the British Generic Manufacturer’s
Association (BGMA).
Cann took over his new role at the
Association’s AGM in London on 26
May. He replaces Kim Innes of Teva,
who will serve as Vice Chair for a year.
NICE
recommends
first biosimilar
NICE has issued its first
recommendation for a biosimilar
product, advising that seven somatropin
products should be funded by the NHS.
The drug is recommended to treat
child growth deficiencies. NICE has
recommended that when more than
one product is suitable, the least costly
option should be chosen.
Carol Blount has joined the ABPI as
Head of Commercial Affairs, bringing
more than 15 years’ senior level
leadership experience within the UK
pharma industry.
Her experience includes leadership
of strategic innovation and change,
business development and brand
marketing leading to increased sales
and contribution.
Michael Cann
Janumet, a new oral treatment for type
2 diabetes, has been launched in the
UK.
The combination tablet combines
metformin, a widely used diabetes
medicine, and Januvia (sitagliptin), a
new generation of medicine in the class
of DPP-4 inhibitors.
Oral
palonosetron
approved in EU
The EMA has approved an oral
formulation of palonosetron (Aloxi) for
the prevention of nausea and vomiting
associated with moderately emetogenic
cancer chemotherapy (MEC).
This positive decision for the secondgeneration 5-HT3 receptor antagonist
from Swiss pharmaceutical group
Helsinn follows the approval obtained
in August 2008 in the USA.
Power
to
the
people
Power
to
the
people
Power to the people
The coalition’s recently unveiled Programme for Government and proposals for a new
Health Bill promise significant change for the NHS. Patient power, value-based pricing
and clinical leadership will take centre stage. But what will it mean for pharma?
Chris Ross examines the rhetoric.
P
lans to review NICE and
introduce value-based pricing
have received a cautious
welcome from the UK
pharmaceutical industry in the wake
of the new coalition Government’s first
announcements on health.
The ABPI has said it supports an
assessment of NICE’s remit and the
way in which it assesses value, but
warned that the move towards valuebased pricing faces some significant
design issues.
The two proposals formed part of a
series of new initiatives unveiled by the
new Government, design to facilitate a
devolution of power and responsibility
within the NHS and give patients and
doctors more control in a clinically-led
health service.
The new approach, outlined by
Cameron and Clegg in their Programme
for Government and expanded upon
within the subsequent Queen’s
Speech, aims to bring an end to the
“bureaucracy, top-down control and
centralisation” it claims has “diminished
the NHS”.
Health Secretary Andrew Lansley
said the new NHS will be one in which
patients enjoy a prominent voice.
“Decisions must be taken with patients,
closer to patients and with clinical
leadership to the fore,” he said.
The BMA has welcomed the pledge
to develop a clinically-led health
service following an increase in NHS
management in recent years, but urged
the coalition to deliver beyond rhetoric.
“Doctors want to work constructively
with the new Government and we
are pleased with plans to prioritise
clinical engagement with the medical
profession. But it is essential that this
dialogue is meaningful and does not
just pay lip service to the notion of
involving clinicians in proposals for the
health service,” said BMA Chairman,
Dr Hamish Meldrum.
Plans to introduce a Health Bill
that cements the coalition vision for
the health service were unveiled in
last month’s Queen’s Speech. The Bill,
which will be put before parliament in
around 18 months’ time, will propose
an NHS run by clinicians and free
from political interference. A flagship
component will be the creation of
an independent NHS Board, which
will be responsible for apportioning
resources and providing commissioning
guidance. It will also give GPs power to
purchase services for their patients.
Other measures include the
establishment of a Cancer Drugs Fund
to enable patients to access the cancer
drugs “their doctors think will help
them”, an increase in the responsibilities
of the Care Quality Commission, and
awarding new powers to Monitor to act
as an economic regulator “to oversee
aspects of access and competition in the
NHS”. Further attempts to improve
efficiencies within the service will see
a reduction in the number of health
quangos in a bid to cut administration
costs in the NHS by a third.
Programme for Government
The Queen’s Speech followed hot on
the heels of the coalition’s Programme
for Government, which was unveiled by
Prime Minister David Cameron and
Deputy Prime Minister Nick Clegg
shortly after the new Government was
formed. The Programme guaranteed a
‘real term’ increase in health spending
in each year of the parliament and an
end to “top-down reorganisations of
the NHS” that it said had “got in the
way of patient care.” The Government
pledged to stop the “centrally dictated
closure of A&E and maternity wards”
and give people better access to local
health services. Key measures outlined
in the Programme include:
Pharmaceutical Field June 2010
Patient power was a central theme in the Health Secretary’s first major speech at the Bromley by
Bow Centre in London, hosted by the Patients Association and National Voices
• NICE reform and a move to valuebased pricing so that all patients
can access the drugs and treatments
their doctors think they need.
• Establishing a Cancer Drugs Fund.
• Strengthening the power of GPs as
‘patients’ expert guides’ through the
health system by enabling them to
commission care on their behalf.
• Prioritising dementia research
within the health R&D budget.
• Setting health targets in key areas
such as cancer and stroke survival
rates and reducing hospital
infections.
• £10 million a year from 2011 to
support children’s hospices.
• A new per-patient funding system
for all hospices and providers of
palliative care.
• An extension of best practice on
improving discharge from hospital –
maximising the number of day care
operations, reducing delays prior to
operations and enabling community
access to care and treatments.
• Helping elderly people live at
home for longer through home
adaptations and community
support programmes.
• The development of a 24/7 urgent
care service throughout England.
• Giving every patient the power to
choose any healthcare provider that
meets NHS standards, within NHS
prices. This includes independent,
voluntary and community sector
providers.
The Programme’s commitment
to end an era of top-down NHS
reconfigurations and instead give
power back to local communities has
been highlighted as a key component
of change. Health Secretary Andrew
Lansley said: “We are committed to
devolving power to local communities
– to the people, patients, GPs and
councils who are best placed to
determine the nature of their local
NHS services. Local decision-making
is essential to improve outcomes for
patients and drive up quality.”
Lansley said he expects decisions on
NHS service changes to:
•
•
•
•
focus on improving patient
outcomes
consider patient choice
have support from GP
commissioners
be based on sound clinical
evidence.
Local NHS organisations that have
started to look at changing services will
need to ensure their plans match these
criteria. Lansley had said he was looking
to NHS London, the biggest authority
in the health service, to lead the way
in working with GP commissioners in
their reconfiguration of NHS services.
However, the head of NHS London,
former GSK Chairman and CEO
Sir Richard Sykes, resigned from his
position late last month following the
new Government’s decision to halt a
wave of hospital reorganisations. Sykes
was said to be furious at the Health
Secretary’s decision to scrap a review
of healthcare in the capital. The review
included the possible closures of some
A&E and maternity units.
Reaction
Reaction to the recent announcements
has been varied. The ABPI said that
the UK is slow to allow patients access
to innovative new medicines, despite
having the lowest prices compared to
other countries – and therefore was
pleased to see the proposed review of
NICE. A spokesperson told Pf: “We
would welcome a review of NICE,
its remit and the way it assesses value,
so that British patients get better
outcomes and access to medicines
available to patients in other countries,
and the NHS spends its total budget
as wisely as possible.”
Its views on value-based pricing,
however, were more cautious –
with its successful implementation
being dependent upon collective
responsibility between the industry,
the Government and the NHS.
“The ABPI strongly supports the
principle that NHS patients should
receive faster access to innovative
new medicines. Industry needs to be
accountable for demonstrating the full
value of medicines, while NICE and
the NHS must put in place systems
commensurate with evaluating this
full value,” it said. “Value-based
pricing (VBP) is clearly a priority for
the new coalition Government, but
faces some significant design issues
– and we look forward to a dialogue
with Government on these issues. No
other country has yet implemented a
full VBP system and its design will be
critical in order to avoid unintended
consequences for patients, the
Government, the NHS and industry
alike. The current PPRS runs until
2014 and, under this scheme, the UK
enjoys the lowest prices in Europe.”
Anna Dixon, Director of Policy
at think-tank The King’s Fund,
said the proposals confirm that the
NHS is embarking upon a period of
significant change. “Strengthening
the role of doctors and the voice of
patients will create some difficult
dilemmas,” she said. “In setting up
an independent NHS board, careful
thought will need to be given to the
relationship between its responsibilities
and those of ministers, who will
remain accountable to parliament for
NHS expenditure”.
“We welcome the acknowledgement
of the critical role played by GPs
within the NHS and the clear signal
that changes are needed to improve
the quality of general practice. If,
as expected, these changes include
transferring budgets to GPs, it will be
important to learn from the previous
experiences of GP-led commissioning
in the UK and other countries to
ensure it delivers benefits for patients
and efficiency savings across the health
system while ensuring accountability
for public expenditure.”
The Health Bill
– at a glance
Purpose:
• To build a sustainable
national framework for the
NHS.
• To support a patient-led
NHS focused on outcomes.
• To reduce bureaucracy.
Benefits
• An NHS led by clinical
decision-makers that is more
responsive to patients.
• A system which drives up
standards of care, eliminates
waste and achieves outcomes.
• A service where patients have
greater choice and control in
decisions about their care.
Policy
• The establishment of an
independent NHS Board to
allocate resources, provide
commissioning guidance and
to allow GPs to commission
services.
• Strengthening the Care
Quality Commission and
developing Monitor into an
economic regulator to oversee
access and competition in the
NHS.
• A reduction in the number of
health quangos, cutting the
cost of NHS administration
by a third.
But analysts have warned of
the dangers of giving financial
accountability to clinicians.
Dean Arnold, head of health
care practice at Deloitte, said:
“Putting patients first is always
a positive thing to do, so too is
empowering clinicians. However,
this requires some caution as
clinicians are not specialists
in cost management – a skill
that will become increasingly
important. With power comes
greater accountability. Patients
should be able to hold clinicians
to account. It can be argued
that today health care managers
and executives are far more
accountable to patients than
clinicians. It will be vital to get
the right ‘checks and balances’
if we are to put the NHS in the
hands of clinicians.”
Could
do
better:
a mid-term report on pharma
market access
Market access has for some years been one of pharma’s most widely used buzzphrases. But now
it is one of its highest priorities. New data shows the industry knows it can no longer pay lip
service to the notion of market access. It can, and must, do better. Chris Ross reports.
A
n overwhelming majority of
pharmaceutical companies across
Europe have conceded the need
to make improvements to their market
access strategies, a new report has shown.
The Cegedim Dendrite Market Access
Industry Report, based on a survey
of almost 200 sales and marketing
executives from across Europe, says that
88% of organisations acknowledge the
need to change their approach to market
access, and that 75% have earmarked
resources to invest in its improvement in
2010/11.
The vast majority of pharmaceutical
companies have already moved to a Key
Account Management (KAM) model
as they seek to align sales and marketing
methodologies with the demands of
the modern marketplace. This is borne
out by the Cegedim Dendrite survey,
which shows that 83% of companies
have taken the KAM approach. The
poll, conducted last month, indicates
that many companies believe the shift
towards KAM will deliver the greatest
benefit to market access strategies. But,
faced with a future without blockbuster
drugs and with a European-wide
reduction in healthcare spending having
a major impact on marketing budgets
and sales operations, successful market
access will require much more than a
restructured field force.
According to the research, the
industry has a number of current
concerns. The most fundamental fear
is, of course, the global economy – with
24% of survey respondents citing it as
the most significant challenge facing
market access. The tough economic
climate has, in turn, been the catalyst
for a whole raft of other concerns for
pharma. Primarily, companies are
worried by the growing influence
of HTA bodies and the increasing
shift in influence from prescribers to
payers. Likewise, the fragmentation of
decision-making across regional bodies
with increasing influence on pricing
and reimbursement locally is a further
cause for concern. The developing
Figure 1
Response to market access challenges
83%
Key Account Management
Health outcome measurement
61%
Leveraging physician peer networks
61%
Promotion of health/well-being
over treatment
43%
Pay-for-performance strategies for
new medicines
25%
Web 2.0 strategies
24%
Other
4%
trend towards the globalisation of
pharmaceutical strategies is another
major worry for market access managers;
while reinforcing brand image may
work at a global level, the report says
that successful market access cannot be
achieved in an increasingly fragmented
market if organisations do not take into
account that local market differences will
cause problems.
A cross-functional
responsibility
So how is pharma responding? Well,
companies are deploying a variety of
approaches (see figure 1), as indicated
by the Cegedim Dendrite survey.
Examination of the respondent profile
(see ‘Survey Methodology’) shows
that market access responsibilities
now extend across the pharmaceutical
organisation. Historically, market access
has been considered the preserve of roles
in health outcome research, but as the
concept has evolved, the involvement
of sales and marketing executives has
grown considerably. The fact that
market research, business intelligence
primary care field force to educate
and inform healthcare professionals,”
says David Round, General Manager,
UK, Cegedim Dendrite. “However,
the current shift towards key account
management teams will continue and
these KAM teams will rely on specific
and increasingly detailed knowledge
of their local health economies, as they
seek to influence the key market access
stakeholders.”
From left to right: Thibaut de Lataillade, Stefan Janssens and David Round
and business development roles are also
represented in the survey demonstrates
the extent to which market access
strategies are now a cross-organisational
concern.
The evolution mirrors progress within
the industry’s customer-base. The vastly
expanding range of stakeholders now
involved in health provision and able
to influence decision-making, which
includes charities and patient bodies
at national level, as well as pharmacists
and nurse practitioners locally, has
underlined the importance of market
access strategies that span the entire
product lifecycle. With the emphasis
now so heavily focused on cost, it is
becoming increasingly important to
communicate with HTAs earlier in
the product development lifecycle,
to gain insight into a product’s
marketing potential. At the other
end of the product lifecycle, ongoing
communication is essential, since the
pricing and reimbursement rates can be
reset at any time, while pressure from
generic prescribing is ever present.
Key Account Management
Research demonstrates that companies
are embarking upon health outcome
measurement in development and postlaunch (61%), leveraging physician peer
networks and interactions (61%) and
the promotion of health and well-being
over treatment of illness (43%). But
the most common response has been
the move to key account management.
Across the industry, companies have
responded to the shift from prescriber
to payer and the declining influence of
local clinicians by dramatically cutting
their field forces and implementing
smaller, more strategic sales teams. But,
say Cegedim Dendrite, creating a new
workforce is only the starting point.
Market access teams need new skill
sets and the ability to communicate
with a range of individuals – from
commissioners to formulary managers
in regional authorities and directors of
local healthcare units, as well as hospital
doctors and, in some regions, primary
care physicians. “These individuals
expect business-led discussions about a
product’s efficacy, its ability to deliver a
financial return and its role in the overall
care pathway,” notes the report. “In
addition to new communication skills
and a very different cultural approach,
KAMs must be supported with excellent
information that identifies the relevant
stakeholders in these regional and local
authority organisations.”
The most notable example of the
growth of ‘payer influence’ in the
UK is, of course, NICE – which has
frequently led the way in European
HTA. The disparate nature of European
healthcare markets has so far prevented
the development of a pan-European
NICE, but despite regional differences,
the wider market faces common health
economic challenges that are driving the
need for market access strategies. “The
fundamental Market Access driver for
all markets is the need to demonstrate
real value to the Care Pathway,”
says Thibaut de Lataillade, Global
Marketing VP, Cegedim Dendrite.
“Even though European markets are at
different levels of maturity, all of them
are implementing Health Technology
Assessment bodies, with a similar key
driver to ensure that the cost of new
treatments delivers acceptable ROI to
the local Health Service.”
In the UK, the rapid increase in payer
influence has propelled a steady decline
in the number of sales representatives
targeting traditional clinicians. The
new coalition Government says it aims
to design a ‘clinically-led NHS’ that
will give power back to prescribers –
but, in a marketplace constrained by
considerable economic imperatives, it
seems highly unlikely that the highvolume, high-frequency model of sales
will ever return. Instead, the smarter,
leaner KAM approach will establish
itself as the norm. “Of course, there
will always be a role for the ‘traditional’
Identifying stakeholders
While pharmaceutical companies
have undoubtedly identified many
of the key changes required to
address a new, complex healthcare
environment, the question remains as
to how effective their responses have
been to date. The key to success is the
effective identification of market access
stakeholders. According to Cegedim
Dendrite’s survey, while pharma
companies appear fairly happy with their
ability to identify key stakeholders, only
7% strongly agree that they can identify
them. This raises questions about the
type and quality of information the
industry gathers about its key customers.
Does it support the complex, multidimensional market access strategies that
are now required? Critically, how much
information do companies collect to
determine stakeholder roles within the
fragmented, multi-tier regional health
environment?
So what do pharma companies
need to do to ensure they respond
to market needs more effectively?
“Based on our experience, and the
detailed results of the survey, the most
important thing that pharma can do is
the implementation of an organisationwide key account management
strategy, with a CRM tool which shares
information effectively across the whole
organisation,” says Stefan Janssens,
President EMEA, Cegedim Dendrite.
“This must be built on a detailed
understanding of the key drivers of the
market access stakeholders that pharma
seeks to influence.”
The future: KAMs at the
centre
Pharmaceutical companies face an even
tougher marketplace across Europe
in the future. A combination of the
increasing influence of non-clinical
stakeholders and the vagaries of the
global economy means that companies
face huge challenges to create and deliver
effective market access strategies. Success
will depend upon building strong
Survey methodology
The Cegedim Dendrite survey was
based on online interviews with 194
individuals from countries across
Europe. The respondent group
worked for companies across the
pharmaceutical sector, with 23%
in organisations employing fewer
than 100 people, 38% in companies
with between 100-500 staff, 20%
in the 500-2000 category and
19% in companies with more than
2000 employees. Respondents were
executives from marketing, market
access, market research and sales
departments.
relationships with every stakeholder
across national and regional health
organisations, as well as the growing
number of associated stakeholders
such as patient groups, charities and
pharmacists. But, says Cegedim
Dendrite, identification of these clinical
and non-clinical stakeholders is just the
beginning. Robust segmentation and
targeting that reflects peer networks of
influence and tailored messaging can
only enable effective market access if
backed up by strong communication
across highly motivated and skilled
KAM teams.
Therefore, the role of the field
force, as part of a cross-functional
organisation-wide effort, remains ever
crucial. The effective consolidation
of market access activities across
organisations is key to supporting a drug
throughout its lifecycle, from initial
pricing and reimbursement decisionmaking, to delivering access to regional
markets. The Cegedim Dendrite report
concludes: “It is those organisations that
understand the new stakeholders and
their networks of influence, that create
the 360 degree customer view and then
leverage that information to deliver
innovative service that truly reflect the
underlying drivers, that will create the
most successful market access strategies.”
Key account managers will sit at the
centre of these strategies. At present,
progress is being made as companies
begin to prioritise market access. But for
now, the industry, in the words of my
fifth form geography teacher, “could do
better.” Sadly, I couldn’t. But you must.
For a copy of the full white paper,
The Cegedim Dendrite Market
Access Industry Report, visit www.
cegedimdendrite.com/ma-report
JULY 2010
‘Compelling,’ but a
‘significant risk’
The Government’s White Paper for the
NHS has been dismissed as a ‘political
experiment’ that could destabilise the
health service.
Critics claim the proposals,
which will see the abolition of PCTs
and SHAs and the emergence of
commissioning led by GP consortia,
represent a significant U-turn from a
coalition Government who only weeks
ago promised there would be no topdown reorganisations of the NHS.
July 2010
A question
of balance p24
A statute
of liberty
p14
Tiers of
influence
p20
‘Compelling,’ but
a ‘significant risk’
Radical new blueprint for the NHS welcomed
and criticised in equal measure.
The Government’s White Paper for the
NHS has been dismissed as a ‘political
experiment’ that could destabilise the
health service.
Critics claim the proposals,
which will see the abolition of PCTs
and SHAs and the emergence of
commissioning led by GP consortia,
represent a significant U-turn from a
coalition Government who only weeks
ago promised there would be no topdown reorganisations of the NHS.
But NHS Chief Executive, Sir
David Nicholson, said the document
– Liberating the NHS – set out a
‘compelling vision’ for an NHS
configured to deliver increasing quality
of services.
“The ambition is high and the
proposed timetable is rapid,” he
said. “The vision needs to be realised
through a period in which the NHS
needs to achieve £15-20 billion
of efficiency savings to reinvest in
improving quality and outcomes.
This represents a significant delivery
challenge.”
Shadow Health Secretary Andy
Burnham labelled the changes a
political experiment. “It is a huge
gamble with an NHS that is working
well for patients,” he said.
Under the new proposals, GPs
will be handed around £80 billion
of the NHS budget to commission
patient care, with vast swathes of NHS
management positions being cut away.
Tens of thousands of jobs in PCTs
and SHAs will be shed in the next
four years. SHAs will be “abolished as
statutory bodies during 2012/13” and
PCTs “from April 2013”.
The reforms will
NHS Chief Executive David Nicholson (right) and
once again redraw the
Health Minister Earl Howe, during the launch of the
pharmaceutical industry’s
health White Paper at 10 Downing Street, London.
customer-base. It will
undoubtedly impact
the industry’s sales
we have seen since the inception of the
methodology – and may well facilitate
a move back towards primary care field NHS in 1948”. It said the plans were
“not without risk” and that some GPs
forces, albeit on a much smaller scale.
would not have the skills to manage the
Andy Lee, Commissioning and
budget. Sir David Nicholson agreed,
NHS Partnerships Director at WG
saying that the scale of change being
Consulting said: “The White Paper
proposed was “unprecedented and
promises significant reform and a
affects all parts of the service”.
renewed focus on quality and patient
“The lesson of past reorganisations
outcomes. However, it appears to
was that there is a ‘significant risk’
offer equal measures of increased
during this transition, of a loss of focus
opportunity and exposure to risk. The
on quality, financial and performance
devil will be in the details and the
disciplines as organisations and
negotiations to follow.”
individuals go through change,” he
The King’s Fund described the
said. (Cont. on p12)
programme as being unlike “anything
For a clearer picture, follow
PharmaField on Twitter
PF-JULY10-NEWS.indd 1
GSK launches
cancer drug
Orencia
approved in EU
A new first-line treatment for
advanced renal cell carcinoma
(RCC) has been launched in Europe
following a conditional EMA
approval.
GlaxoSmithKline’s Votrient
(pazopanib) is now available for the
first-line treatment of patients with
advanced RCC and for patients who
have previously received cytokine
therapy for advanced disease.
Orencia (abatacept) has been approved
in the EU as the first choice biologic to
treat active rheumatoid arthritis (RA)
after the failure of disease-modifying
anti-rheumatic drugs (DMARDs).
approved the drug, in combination
with methotrexate (MTX), for the
treatment of adult patients who have
not responded to previous therapy
with one or more DMARDs including
MTX or a TNF-alpha inhibitor.
15/07/2010 15:02
CannabisABPI to
based MS drug remove
launched
promo gifts
Sativex Oromucosal Spray has
become the first medicine available
in the UK to contain both delta9-tetrahydrocannabinol (THC)
and cannabidiol (CBD) from the
cannabis sativa plant.
The drug has been licensed as an
additional treatment for people with
Multiple Sclerosis (MS) experiencing
the debilitating symptoms of
spasticity, such as painful spasms and
cramps. It is indicated for patients
with moderate to severe spasticity
due to MS who have not responded
adequately to other anti-spasticity
medication and who demonstrate
clinically significant improvement in
spasticity-related symptoms during
an initial trial of therapy.
Warnings over
drugs’price
cuts
Cutting drug prices will severely
reduce the number of new
medications making it to market,
according to a study from ESMT
Competition Analysis (ESMT CA).
New medications likely to be
hit hardest under tough pricing
regulation include antibiotics, as
well as treatments for cardiovascular
disease and immune system disorders
such as multiple sclerosis and chronic
meningitis, the research has shown.
Many of the promotional items
currently given to doctors will be
outlawed if current proposals to
amend the ABPI Code of Practice are
approved.
The recommendations, which have
been agreed by the ABPI Board of
Management, are currently available for
comment on the PMCPA website. The
consultation period will close on Friday
13 August 2010.
EU pharma
leading the
way
European pharma companies are still
leading the way in making medicines
available to people in developing
countries, the second Access to Medicine
Index has shown.
Compared to 2008, when the first
Index was published, pharma companies
have given more insight into their
policies to increase access to medicines,
say the researchers. They identify more
industry initiatives than two years ago,
but also see room for improvement.
First new class of
COPD treatment
for a decade
Chewable
Lipitor now in
Europe
A new chewable form of Lipitor
(atorvastatin calcium) suitable for use
in children aged 10 or older has been
approved by the European Commission.
Pfizer could receive a further six months’
patent protection on Lipitor as a result of
securing this paediatric indication.
Nycomed’s anti-inflammatory therapy
Daxas (roflumilast) has received a
marketing authorisation in the EU for
patients with COPD associated with
chronic bronchitis.
It represents the first new class
of treatment for COPD in more
than a decade. Daxas is indicated
for the maintenance treatment of
patients with a history of frequent
exacerbations as an add-on to
bronchodilator treatment.
HAVE YOUR SAY
New indication for Tyverb
The EMA has granted a new indication
for GSK’s oral breast cancer treatment
Tyverb (lapatinib).
Approval was given for Tyverb,
in combination with an aromatase
inhibitor (AI), to treat postmenopausal
women with hormone receptor (HR)positive, ErbB2 (HER2) over-expressing
metastatic breast cancer, based on
evidence that it can increase progressionfree survival (PFS) by more than five
months in this indication.
JULY 2010
DH wants to
GIST drug
receives negative end targets
draft guidance
recommend Novartis’ Glivec (imatinib)
as an adjuvant treatment for people
who have had a gastrointestinal
stromal tumour (GIST), despite the
provision of further information by the
manufacturer.
In March this year, the Appraisal
Committee requested further data
from Novartis to address uncertainties
relating to the clinical effectiveness and
cost-effectiveness of the treatment.
U-turn on
Alimta
NICE has reversed its opinion of
Eli Lilly’s Alimta (pemetrexed) as a
maintenance treatment for patients
with non-small-cell lung cancer.
Despite issuing draft guidance
opposing the drug in December 2009,
NICE has now recommended Alimta
in its final appraisal determination.
Anger over
Mepact
decision
Patient groups have responded angrily
to NICE’s decision not to back
Takeda’s bone cancer treatment Mepact
(mifamurtide).
recommend the drug due to a lack of
evidence that it significantly increases
the overall survival of patients compared
to current treatments. This is despite
Takeda’s proposal to make the drug free
of charge for a patient’s first seven doses.
Cutting management costs and
freeing the NHS from bureaucracy
will result in benefits for patients,
Health Secretary Andrew Lansley said.
A revision to the 2010/11 NHS
Operating Framework sets out changes
to key priorities for the NHS,
including plans to reverse the rise in
management costs seen in the last year
and changes to the use of targets.
NICE rejects
Yondelis
NICE rejects
Herceptin
Yondelis (trabectedin) has not been
recommended for use on the NHS as
the manufacturer PharmaMar did not
supply enough evidence in its favour.
This is the conclusion of NICE’s
appraisal of the drug, which is
indicated in combination with
pegylated liposomal doxorubicin
(PLDH) for the treatment of relapsed
ovarian cancer that is sensitive to
platinum-based therapies.
NICE has failed to recommend
Roche’s Herceptin (trastuzumab) for
use in stomach cancer due to doubts
over the extent to which it can extend
life.
In preliminary draft guidance,
NICE said it is “unable” to
recommend Herceptin in
combination with cisplatin and
capecitabine or 5 fluorouracil for the
treatment of people with HER2positive metastatic gastric cancer.
DH pilots new
scheme
Andrew Lansley
NICE says no
to Tarceva
NICE says it is unable to recommend
Tarceva (erlotinib) as a maintenance
treatment for people with non-smallcell lung cancer.
Despite a proposed patient access
scheme by manufacturer Roche,
in which the cost of Tarceva would
be reduced by 14.5%, the appraisal
committee concluded that the drug
“would not be a good use of NHS
money”. It was also ruled that the
total population for whom Tarceva is
licensed is not small enough to qualify
for the end-of-life criteria.
Good news for
RA patients
NICE has issued new recommendations
on treatments for rheumatoid arthritis
(RA), following the advice of clinical
experts.
Roche’s MabThera (rituximab),
Abbott’s Humira (adalimumab),
Wyeth and Pfizer’s Enbrel (etanercept),
Schering-Plough’s Remicade
(infliximab) and Bristol-Myers Squibb’s
Orencia (abatacept) have all been
recommended as possible treatments for
rheumatoid arthritis after treatment with
a TNF inhibitor has failed.
The DH is piloting the first direct-topatients payment scheme, which it
promises will offer patients more choice
and control over their healthcare.
Eight Primary Care Trusts will
begin to road-test direct payments for
personal health budgets. Under the
scheme, Primary Care Trusts will give
the money for someone’s care directly
to them, allowing individuals to decide
how, where and from whom they
receive their healthcare.
‘Disappointing
blow’ for
patients
NICE has decided that the benefits of
Novartis’ Afinitor (everolimus) do not
justify its high cost.
In draft guidance, the Institute has
not recommended the drug for NHS
funding for the second line treatment of
advanced renal cell carcinoma.
New BMA
president
Sir Michael Marmot will be setting
out to tackle health inequalities over
the next year in his role as the new
President of the British Medical
Association.
A world expert in the social
determinants of health, Sir Marmot
chaired the WHO Commission
which produced its report in 2008
entitled Closing the gap in a generation:
health equity through action on social
determinants of health.
PCTs rely on
pharma for
training
PCTs have been warned not to rely
too heavily on pharma companies to
provide education for practice nurses.
However, several NHS organisations
recognise the value of working with
industry and are in talks to set up more
formal joint working arrangements,
HSJ has reported.
A statute
of liberty
Liberating the NHS, the Government’s blueprint for healthcare in the UK, proposes an
unprecedented and radical reorganisation for the NHS. Still ‘free at the point of use’, the
White Paper remains true to the core principles of the NHS. But its desire to provide
patients with the freedom of choice and, crucially, GPs with the freedom to commission
services, suggests some challenging times lie ahead. In these turbulent economic times, not
all that is good can be free. Chris Ross takes an early glance at the White Paper.
S
trategic Health Authorities
(SHAs) and Primary Care Trusts
(PCTs) are to be scrapped and
hospitals encouraged to move out of
the NHS to create a ‘vibrant’ industry
of social enterprises, as part of radical
proposals to restructure the NHS in
England.
The new White Paper, Equity and
Excellence: Liberating the NHS, outlines
how power will be devolved from
Whitehall to patients and professionals
– and gives GPs freedom to take charge
of much of the budget.
GP consortia
Consortia of GPs will be given the
responsibility for buying care from
local hospitals and other providers
as the balance of purchasing power
shifts from central management to
the GP surgery. The consortia will
control upwards of 70% of the NHS
budget – approximately £80 billion.
The majority of commissioning will be
undertaken by GP-led consortia – with
the rest being done by a new NHS
Commissioning Board.
The NHS Commissioning Board will
be “a lean and expert organisation, free
from day-to-day political interference,
with a commissioning model that
draws from best international practice”.
The White Paper states that the Board
will: “support GP consortia in their
commissioning decisions and provide
leadership for quality improvement
through commissioning: through
commissioning guidelines it will
help standardise what is known good
practice, for example improving
discharge from hospital, maximising
the number of day care operations,
reducing delays prior to operations
and enabling community access to care
and treatments. It will not manage
providers or be the NHS headquarters.”
Subject to consultation, the
Government’s indicative timetable for
GP consortia is to be as follows:
• A comprehensive system of GP
consortia in place in shadow form
during 2011/12, taking on increased
delegated responsibility from PCTs.
• Following passage of the Health Bill,
consortia to take on responsibility for
commissioning in 2012/13.
• The NHS Commissioning Board to
make allocations for 2013/14 directly
to GP consortia in late 2012.
• GP consortia to take full financial
responsibility from April 2013.
The abolition of PCTs, which
will take place ‘from 2013’, is seen
as a major policy u-turn for the new
government, having ruled out topdown NHS reorganisations in the
coalition Programme for Government
back in May. However, Health
Secretary Andrew Lansley said the
about turn was simply because his
other reforms had left nothing for
PCTs to do. “If we don’t have a
job for primary care trusts to do,
it doesn’t make sense to be paying
thousands of people to do it,” he said.
The policy is expected to result in
tens of thousands of redundancies,
with the cost of NHS management
aiming for a 45% reduction over
the next four years. “Inevitably, as a
result of the record debt, the NHS
will employ fewer staff at the end of
this Parliament,” said Lansley. “That’s
a hard truth which any government
would have to recognise.” The NHS
is charged with finding efficiency
savings of £20 billion during the same
period in which it hopes to drive
through the reforms.
Pharmaceutical Field July 2010
Foundation trusts
The White Paper says that all NHS
Trusts will become Foundation Trusts
within three years. This, it says, will
create the largest and most vibrant
social enterprise sector in the world.
“The intention is to free foundation
trusts from constraints they are under,
in line with their original conception,
so they can innovate to improve care
for patients. It will not be an option
for organisations to remain as an NHS
Trust, rather than become or be part
of a foundation trust.” The NHS Trust
legislative model will be repealed in due
course, while SHAs will be abolished
by 2012 – and their responsibilities
in relation to providers will be
undertaken by a new unit within the
Department of Health. From April
2013, responsibility for regulating all
providers of NHS care will be passed to
Monitor.
evidence shows that involving patients
in their care and treatments improves
their health outcomes, boosts their
satisfaction with services received, and
increases not just their knowledge and
understanding of their health status
but also their adherence to a chosen
treatment. It can also bring significant
reductions in cost, as highlighted in
the Wanless Report, and in evidence
from various programmes to improve
the management of long-term
conditions.”
Information generated by patients
will be critical to the process, and
will include much wider use of
tools such as Patient-Reported
Outcome Measures (PROMS),
patient experience data and realtime feedback. The use of PROMS
and other outcome measures will be
expanded across the NHS, while the
DH will extend national clinical audits
to support clinicians across a wider
range of treatments and conditions.
David Cameron and Andrew Lansley speak with a group of nurses during a visit to The Royal
Marsden hospital in London, on the same day that the White Paper was launched.
role of NICE will also be expanded
to develop quality standards for social
care.
The White Paper notes the absence
of an effective payment system within
the NHS which it says restricts the
ability of commissioners and providers
to improve outcomes, increase
efficiency and deliver patient choice.
Responsibility for the future structure
Patient choice
of payment systems will belong to the
The Government aims to make the
NHS more accountable to patients,
NICE and quality standards NHS Commissioning Board and the
economic regulator will be responsible
who, it says, will be at the heart of
The Government says the central aim
everything it does. As such, the White
of its programme of reform, and indeed for pricing. The DH plans to refine the
basis of current tariffs and to accelerate
Paper promises patients will have
of the NHS, is the drive to improve
more choice and control, which will
health outcomes. Progress on outcomes the development of best-practice tariffs,
introducing an increasing number
be supported by easier access to the
will, it says, be supported by quality
each year so that providers are paid
information they need about the best
standards. These will be developed for
according to the costs of ‘excellent
GPs and hospitals. The ‘information
the NHS Commissioning Board by
care’ rather than average care. Bestrevolution’ promised by Lansley has
NICE, who will develop authoritative
practice tariffs for interventional
spawned a new slogan to sum up the
standards setting out each part of the
radiology, day-case surgery for breast
approach to patients: ‘no decisions
patient pathway, and indicators for
surgery, hernia repairs and some
about me, without me.’
each step. NICE will rapidly expand
orthopaedic surgery will be introduced
To help deliver this, a new body,
its existing work programme to create
in 2011/12. Alongside this, the DH
HealthWatch, will be set up to
a comprehensive library of standards
will also extend the scope and value
compile data on performance, while
for all the main pathways of care. The
of the Commissioning for Quality
GP boundaries will be abolished to
first three on stroke, dementia and
and Innovation (CQUIN) payment
allow patients to register with any
prevention of VTE were published in
framework.
doctor they want.
June. NICE expects to produce 150
The Paper says: “We want the
standards within the next five years
principle of ‘shared decision-making’
and, to support quality standards, will
Value-based pricing
to become the norm: no decision
advise the National Institute for Health Reforms to the way in which
about me, without me. International
Research on research priorities. The
drug companies are paid for NHS
medicines are also on the way, with
proposals to move to a system of
value-based pricing when the current
scheme expires. “This will help ensure
better access for patients to effective
drugs and innovative treatments on
the NHS, and secure value for money
for NHS spending on medicines,”
the White Paper states. As an interim
measure, the DH is creating a new
Cancer Drug Fund, which will operate
from 2011. “This fund will help
patients get the cancer drugs their
The Prime Minister and Health Secretary with Professor Steve Field, Chairman of the Royal
doctors recommend.”
College of GPs, during the launch of a health White Paper at 10 Downing Street, London.
ABPI response
The ABPI has welcomed the proposals,
in particular the extended remit of
NICE which, it says, will help it
move beyond a narrow focus on the
cost-effectiveness of medicines. Dr
Richard Barker, Director-General at
the ABPI, said: “We warmly welcome
the Government placing outcomes at
the heart of health policy, a move we
have long advocated. We must ensure
that the new era of commissioning
builds in the intelligent prevention,
early diagnosis and timely treatment
necessary to halt the burden of
chronic disease that threatens the
financial future of the NHS. The NHS
spends more on unplanned hospital
admissions for chronic disease sufferers
than it does on medicines that, if used
appropriately, could prevent them.”
The move towards a more
clinically-led NHS is also supported.
“We are also pleased that the White
Paper signals a move towards greater
doctor and patient influence over
clinical decisions. We agree with
Government that it is important to
set quality standards for the new era
of GP-led commissioning and we
welcome the involvement of NICE
in this process. The ABPI believes
that this expansion of NICE’s remit
to promote clinical best practice is a
higher priority for the future of the
NHS than the overly narrow costeffectiveness calculations on new
medicines it currently conducts. The
new Government also proposes to
introduce a Cancer Drugs Fund and
to review how better to reflect value
in the pricing of NHS medicines.
We look forward to working with
the Government to develop these
proposals further whilst maintaining
the stability of the current PPRS
agreement.”
Tiers of Influence
The NHS may be changing, but some challenges remain the same. The battle pharma
companies face is not simply to identify Key Opinion Leaders at local, regional, national and
even international level, but to understand the different roles these individuals play and how
they interact to create a Market Access influence network. Richard Gray explains.
T
he complexity of
introducing a new drug
into the NHS with a view
to open up prescribing at local
level has changed quite drastically
over the past few years. The shift in
emphasis from clinicians to payers
and the growing significance of
national and regional bodies has
fundamentally transformed, not
only the stakeholders, but also
the shape of teams within many
pharmaceutical companies.
Most notable has been the
expansion of pharmaceutical
sales people operating at a more
senior level within their customer
accounts. Companies now have
to consider the key national
organisations such as Health
Technology Assessment (HTA)
bodies and the influence of patient
advocacy groups and charities, as
well as the explosion in regional
decision makers, from Medicines
Management committees
to regional procurement
organisations.
Furthermore, it is becoming
increasingly clear that national
boundaries are being blurred.
While each European country will
undoubtedly continue to make
its own drug approval decisions
for some time to come, there is
growing communication and
collaboration between national
HTAs. There is also evidence that
local clinicians in the UK are
increasingly as likely to consider
the recommendations of SMC
and SIGN in Scotland, IQWIG
in Germany and AIFA in Italy
as those of NICE in England, or
the All Wales Medicines Strategy
Group (AWMSG) in Wales.
This extension of the sphere
of influence across national
boundaries now creates the need
to track the interaction of KOLs
across Europe; to highlight specific
disease areas in which collaboration
and communication is greater;
and to understand the extent of
individual and HTA influence on
clinicians.
Expanding remit
One of the greatest shifts now
facing pharmaceutical companies
is the need to significantly ramp
up activity at a strategic, national
level. While historically, lobbying
parliamentary groups and
collaborating with charities was the
role of a single Policy and Affairs
Manager, today this role requires
an entire team. There are now
large numbers of national bodies,
including HTAs to consider.
Patient advocacy groups and
charities also have huge influence,
taking a key role in many HTA
committees, influencing care
pathways and, in many cases,
leveraging significant financial
resources to lobby parliament.
Many of these individuals
will have multiple other roles
at regional and local level,
offering many opportunities
for pharmaceutical company
interaction – creating the need for
a strong Market Access team able
to track interactions at every level
and across these diverse spheres of
influence. In fact, there is evidence
to suggest that pharmaceutical
companies who do not track and
manage individual interactions
at all levels of their organisation
may actually be harming the
reputation of their company at a
regional or local level. A traditional
pharmaceutical sales call made by
an inexperienced representative on
a GP may not immediately trigger
alarm bells, but if that GP is the
PCT Lead on a purchasing or
prescribing committee, damage to
the relationship may occur.
Indeed, in addition to increasing
the expertise and experience within
Policy and Affairs, pharmaceutical
companies are having to address
the new regional tier for the first
time. Whilst most organisations
will have, in the past, made little
attempt to build relationships with
the Strategic Health Authorities
(SHA), preferring to work with
This extension of the sphere of influence across
national boundaries now creates the need to
track the interaction of KOLs across Europe;
to highlight specific disease areas in which
collaboration and communication is greater;
and to understand the extent of individual and
HTA influence on clinicians
clinicians at Primary Care Trust
(PCT) and GP level, the growth
in regional procurement strategies
is creating a new group of
stakeholders.
With the emphasis on cost
containment, the remit of regional
procurement has expanded from
the traditional focus on disposables
to incorporate drug acquisition.
These stakeholders are primarily
focused on finance and are looking
for discounts and opportunities
to collaborate with other regional
bodies to further drive down the
cost of drugs, which requires
pharmaceutical companies to create
and deliver individual messages.
Clinical relevance
In addition, there are a number of
emerging disease specific groups,
including cancer and cardiac
networks, that are operating at a
regional level. The UK Medicines
Information Centre has 14 regional
centres and has a huge influence on
prescribing; as does the National
Prescribing Centre, which works
alongside NICE to distil and assess
new drug evidence and provide
advice to prescribers.
Furthermore, many of these
regional groups work together:
decisions made by one Commercial
Support Unit (previously
Procurement Hub) or Medicines
Management group are often
repeated across the country. It is
therefore essential, not only to
identify these groups, but also to
track decision making and assess
which groups are leading the way
in both procurement strategy and
pharmaceutical decision making.
It will also be important to
reinforce the work done at national
level with patient advocacy
bodies and charities at both a
regional and local level. Most of
these organisations focus their
attention on national bodies, and
undertake local patient-centric
communication. There is therefore
a key role for pharmaceutical
companies to ensure joint
projects, messaging and disease
specific developments are clearly
disseminated to the new regional
stakeholders.
Political change
Given the efficiency drive that
must now be put in place in order
to attain the estimated £20 billion
savings required across the NHS,
it is also clear that rationalisation
at management level is likely. The
Government’s new White Paper
promises a major reorganisation of
the NHS, with PCTs and SHAs
facing a slow death. The long-term
impact of this remains unclear
and, with change likely to occur in
steady phases, pharma’s customerbase and targeting strategies will
not change overnight.
The reforms, combined with a
need to drive greater cost savings at
every level of the NHS, will place
further emphasis on the regional
procurement bodies. Throughout
this time it will be essential to track
changes, assess the impact on KOLs
and networks of influence and
rapidly assimilate the implications
of new strategy, such as a renewed
emphasis on generics or a stronger
adherence to the QIPP agenda.
Irrespective of the speed of change
and moves towards a clinicallyled health service, the influence
of payers will continue. However,
it is also important to recognise
that this influence is inconsistent.
Disease areas typically treated in
primary care, such as hypertension,
are highly influenced by both the
HTA and PCT. In secondary care
and some specialist areas, clinicians
retain control. And there are also
local drivers that reflect the health
needs of local communities and, in
some cases, the personal goals of that
individual.
In this complex, fragmented
marketplace the goal is not just to
identify the new breed of nonclinical stakeholders – although this
is essential since the number of nontraditional stakeholders has increased
significantly – but also to understand
how these stakeholders interact at a
national, regional and local level and
to determine an accurate network
that spans these tiers of influence.
Richard Gray is Commercial
Director (CCI) for Cegedim
Dendrite, responsible for their
segmentation and targeting
services and KOL / stakeholder
mapping.
19
A question of balance
The Pf Survey measures the happiness of the pharma workforce, what motivates
them and which companies are viewed as the best employers. The latest results
reveal that many companies are not striking the right balance in meeting the needs
of their employees. Pf ’s Diana Spencer provides an overview.
T
he Pf Company Perception,
Motivation and Satisfaction
Survey, now in its ninth
year, provides an annual temperature
check of workforce attitudes to
their own and other companies
within the industry. It also compares
remuneration packages and use of
technology such as ETMS systems.
The latest research has shown
that many respondents are worried
about the future. It is evident that
there is concern over the industry’s
pipeline and lingering insecurity
following recent company mergers
Figure 1: Overview of respondents
2009
2008
2007
2006
2005
2004
2003
2002
Number of respondents
1,214
1,479
1,552
2,212
1,507
1,503
2,005
1,843
Most frequently represented age group
35-44
35-44
35-44
25-34
25–34
25–34
25–34
25–34
Male/Female (%)
47/53
44/56
45/55
47/53
47/53
46/54
48/52
47/53
Primary care and primary & secondary
care representatives (%)
39
37
39
43
49
57
53
55
Hospital specialists (%)
24
27
32
30
29
22
22
20
1st line managers (%)
10
10
11
11
11
12
11
10
More than 2 years’ experience (%)
45
28
90
88
90
81
89
84
More than 8 years’ experience (%)
13
66
59
50
51
38
40
41
and redundancies amongst the sales
force. On a positive note, however,
the majority of respondents have
great belief in the products they are
currently promoting.
The company with the best external
perception as an employer has
remained consistent, with Boehringer
Ingelheim securing the top position
as an employer of choice for the third
year running.
The respondents
As usual, response to the survey was
high, though the lowest in recent
years, which could reflect lower
numbers of people in the industry.
Figure 1 provides an overview of
the survey’s respondents. Data from
the last eight years demonstrate that
there has been an overall increase
in the average age of respondents,
which was 25-34 until 2006, and
that there is a trend towards a
decreasing number of people in
representative roles. This is hardly
surprising given the large number of
redundancies that have taken place
and a lower rate of recruitment in
the last few years. However, the
table also shows there has been
consistency since 2007 in the average
age of respondents and the number
of representatives that responded,
which could reflect greater stability
across the industry over the last three
years.
One striking difference in the
demographic of respondents is the
reduction in those with more than
eight years’ experience within the
industry. Despite a fairly steady
increase in numbers between
2002 and 2008, the percentage of
respondents with more than eight
years in the industry dropped in
2009 from 66% to just 13%. The
data also show a higher number of
people with two years’ experience
than last year, though this is still
a significant drop on the previous
seven years.
There could be various reasons
for this disparity. It could be due to
job cuts among more experienced
and therefore expensive members of
staff as a result of company mergers,
due to people leaving the industry
or, more positively, that people with
long service are securing promotions
to other departments or new roles
and feel they are either too busy or
no longer qualify for the survey.
Figure 2: Employer of choice rankings
2009
2008
2007
2006
2005
1
Boehringer Ingelheim
Roche
Roche
2
Roche
Roche
Roche
3
Novo Nordisk and
Eli Lilly
Novo Nordisk
Schering-Plough and
Eli Lilly
Eli Lilly
Sanofi-aventis and
Eli Lilly
4
Eli Lilly
Sanofi-aventis
5
Abbott
Schering-Plough
Sanofi-aventis
Schering-Plough
Schering-Plough
6
Napp
Napp and Abbott
Laboratories
Procter & Gamble
Janssen-Cilag
Janssen-Cilag and
Schering Healthcare
7
Novartis and BristolMyers Squibb
Novartis and Novo
Nordisk
Schering Healthcare
Novartis and Sanofiaventis
8
9
Leo
10
Bayer Schering
Pharma, Janssen-Cilag
and Sanofi-aventis
Novartis
Napp, Wyeth and
BMS
Bristol-Myers Squibb,
Leo and Janssen-Cilag
GSK and Procter &
Gamble
Wyeth
Procter and Gamble
Novartis
Company perception
The Employer of Choice section of
the survey asks respondents to rank
companies, with the exception of
their own, on how desirable they feel
they would be to work for.
2009 was another successful year
for Boehringer Ingelheim, which
keeps its crown as the most admired
employer for the last three years.
Indeed, both Roche and Boehringer
Ingelheim have succeeded in
securing the top two positions since
2005.
A previous top employer, Eli
Lilly has also performed well since
the origins of the survey and has
improved its position this year to
reach third place. Bristol-Myers
Squibb too has performed well
in improving its ranking by three
places.
Recent large-scale company
mergers have obviously had a
significant impact on the survey
results in the last few years. It is
notable that Schering-Plough has
dropped out of the top ten following
its merger with MSD. However,
Bayer Schering Pharma’s ninth place
position perhaps reflects a higher
level of success in the management
of this fairly large-scale acquisition.
Newer additions to the top
ten, Novo Nordisk and Leo have
consolidated their positions, Novo
Nordisk maintaining its third place
after moving up four places last
year and Leo improving its top ten
ranking after its first appearance
there in 2008. The most impressive
rising through the ranks for 2009
were achieved by Ipsen, improving
seven places to 29th, Eisai, up six
to 27th, UCB, up five to 29th and
Norgine, up five to 21st place.
Motivation factors
As part of the research, respondents
are asked to rank 18 work factors
in terms of how important they
feel they are and how satisfied they
are with these areas at their current
company.
Again there is consistency in
the responses over the last two
years, demonstrating that pharma
employees’ priorities have not
really changed since 2008. The
most notable variation in terms of
motivation is that the respondents
of 2009 place greater significance
on company culture than belief
in products, making the top five
priorities when seeking an employer:
salary, relationship with direct
manager, work-life balance, job
security and company culture.
After the honest admission that
salary matters most, respondents
have placed value on more quality
of life and relationship factors,
signifying that these ‘softer’ company
benefits remain very important to
employees. It is unsurprising that
job securityis still a top priority
for the workforce. Although there
is more security throughout the
industry, most respondents will
have experienced redundancy, either
themselves or through the eyes of a
colleague, and have not forgotten the
impact this can have.
Satisfaction data for 2009 reveal
that respondents are still most
happy with the products that they
are currently promoting, but their
concern over the future pipeline
is evident, revealing an awareness
of the industry’s current pipeline
worries due to patent expiries and
low numbers of potential new
blockbusters.
Car policy is also a downside for
many, although salary is still midway up the table, demonstrating
that this is not an area of particularly
low satisfaction. It reflects badly
on companies that two of the
top five work factors in terms of
motivation feature very low down
for satisfaction: work-life balance
and job security, indicating that
employers are not doing enough to
improve working hours and reduce
insecurity amongst their employees.
(As the top motivation factor, Pf
will expand on the area of salary
in August – find out how your
remuneration package compares to
the rest of the industry.)
Future plans
The survey also asks respondents
whether they are planning a move
in the next 12 months, and Figure 4
breaks this down by the key roles.
The fairly low numbers of
respondents intending to remain in
the current role over the next year
could be due to the low levels of
satisfaction with important work
factors. However, this could also be
attributed to a greater number of
roles becoming available and people
expecting to receive promotions.
The industry professionals revealing
greatest unhappiness in their current
roles are hospital specialists, with
a high 24% planning to move
company in the next year and just
49% intending to remain where they
are. These results could reflect an
increased number of opportunities for
these professionals across the industry.
It is also significant that high
numbers of healthcare development
managers (HCDs) and key account
managers (KAMs) are planning to
move position, as many of these
could be looking towards a role in
sales management.
Career development, improved
benefits and job security were top
reasons given for a move of role,
indicating that most professionals
have hopes of moving onto ‘better
things’. Lifestyle, work recognition,
relationship with manager and
product quality also featured in the
Figure 3: Motivation and satisfaction factors
What motivates you?
What are you most satisfied with?
2009
2008
2009
2008
1
Salary
Salary
Belief in products
Belief in products
2
Relationship with manager
Relationship with
manager
Future pipeline
3
Work-life balance
Work-life balance
Accountability
4
Job security
Job security
Autonomy
Accountability
5
Company culture
Belief in products
Additional responsbilities
Car policy
6
Belief in products
Company culture
Pension scheme
Pension scheme
7
Bonus
Recognition of success
Company culture
Additional responsibilities
8
Recognition of success
Bonus
Future pipeline
Autonomy
9
Autonomy
Personal development
Share scheme
10
Autonomy
Salary
Salary
11
Pension scheme
Future product pipeline
Recognition
Job security
12
Future product pipeline
Pension scheme
Car policy
Company culture
13
Car policy
Car policy
Training
14
Accountability
Additional
responsibilities
Appraisal system
Recognition
15
Additional responsibilities
Accountability
Work-life balance
Appraisal system
16
Training
Training
Job security
Training
17
Share scheme
Appraisal system
Bonus
Work-life balance
18
Appraisal system
Share scheme
Share scheme
Bonus
Figure 4: Future plans
Position
Move company
Move position
Remain
1st line managers
16%
23%
56%
NHS liaison/HCD
15%
33%
46%
Representatives
15%
25%
55%
KAMs
15%
31%
50%
Hospital specialists
24%
23%
49%
The Pf Company Perception, Motivation and Satisfaction Survey has been
conducted annually by HSP, publishers of Pf, since 2002. It provides a
benchmark of field force remuneration, motivation, satisfaction, perception
and recruitment. As the survey is managed by Dr B Payne of Conker
Statistics (A fellow of the Royal Statistical Society) and respondents are
anonymous, it is able to provide a unique and impartial snapshot of
workforce attitudes at the time the research is
conducted. These latest results were gathered in
early 2010, but relate to 2009.
AUGUST 2010
US investigating bribery
claims
The US Department of Justice (DoJ) has
launched an international investigation into
corruption in the pharma sector.
The probe, being conducted jointly with
the Securities and Exchange Commission
(SEC), is looking into payments made
by pharma companies for hospitality,
consultants, licensing agreements and
charitable donations in markets outside
the US. It follows allegations that certain
companies may have violated US anti-bribery
law, the Foreign Corrupt Practices Act.
Cancer fund
could save
hundreds
An extra £50 million is to be made
available to help patients access
innovative new cancer drugs, the
Government has revealed.
The fund, due from October,
precedes the promised Cancer Drugs
Fund due to commence in April
next year. Doctors will be put in
charge of deciding how the funding
is spent based on the advice of cancer
specialists.
David Willets
UK lags behind,
says ABPI
UK patients are not seeing the
benefits of the country’s R&D
efforts, says the ABPI.
The DH report, Extent and
Causes of International Variation in
Drug Usage, says that the UK lags
behind its European counterparts
in providing access to medicines,
particularly new cancer drugs.
Boosting your
confidence p24
Does money
matter? p22
August 2010
Food for
thought p26
US investigating pharma
bribery claims
The US Department of Justice (DoJ) has
launched an international investigation
into corruption in the pharma sector.
The probe, being conducted jointly
with the Securities and Exchange
Commission (SEC), is looking into
payments made by pharma companies
for hospitality, consultants, licensing
agreements and charitable donations
in markets outside the US. It follows
allegations that certain companies may
have violated US anti-bribery law, the
Foreign Corrupt Practices Act.
A number of leading pharma
companies, including some of the biggest
players in the industry, have disclosed
being contacted by the DoJ and SEC
in connection with the investigation
in recent months. Currently, at least
11 companies are co-operating with
investigators.
The probe is assessing whether corrupt
payments may have influenced the
reliability and integrity of clinical data
from studies undertaken outside the US.
The recruitment of physicians for clinical
trials will also come under the microscope
– in some countries, the same physicians
may serve on the regulatory boards that
approve drugs. Hospitality activities are
also being scrutinised.
Under the Foreign Corrupt Practices
Act, companies may not offer items of
value to foreign government officials for
profit. US law considers doctors, clinicians
and regulators in foreign markets to be
‘government officials’ because they are
employed by state-owned facilities.
Alexandra Wrage, President of Trace,
a not-for-profit organisation that helps
companies establish anti-corruption
practices, told the Financial Times that
alleged wrongdoing at pharma companies
could centre on ‘inappropriate, lavish
hospitality’ – such as wining and dining
doctors. “What we hear is not that doctors
are expecting cash. But that doctors are
only going to give companies time in
front of a meal or a training session,”
she said. In the UK, ABPI regulations
governing hospitality have been tightened
significantly in recent years. The FT
reports that legal experts believe the DoJ
is examining ‘egregious behaviour that
smells of bribery’.
AstraZeneca makes Seroquel settlement
AstraZeneca is to pay $520 million to resolve allegations that they illegally
marketed the anti-psychotic drug Seroquel for uses not approved as safe and
effective by the FDA. Such unapproved uses are also known as ‘off-label’
because they are not included in the drug’s FDA approved product label.
“Illegal acts by pharmaceutical companies and false claims against Medicare
and Medicaid can put the public health at risk, corrupt medical decisions by
health care providers, and take billions of dollars directly out of taxpayers’
pockets,” said US Attorney General Eric Holder.
ABPI Code set for more changes
UK pharmaceutical companies will have
to declare exactly how much money
is spent on sponsoring and paying
consultants if new proposals are agreed.
The Prescription Medicines Code
of Practice Authority (PMCPA) has
published a public consultation on its
second round of proposed amendments
to the ABPI Code of Practice.
Phase two of the changes covers the
employment of healthcare professionals
(HCPs) to act as consultants, such
as to speak at meetings or attend
advisory boards, and sponsoring HCPs
to attend meetings. However, many
pharmaceutical companies are already
publishing such figures on a regular
basis.
The PMCPA suggests that
companies should “make publicly
available details of the fees paid to
consultants in the UK”. Companies
will be required to disclose how many
consultants were employed and the
total amount that was paid to them
at the end of each year from 2012
onwards. It has not been deemed
necessary for each consultant to be
named.
Phase two also includes a
recommendation that Clause 18,
which previously referred to “gifts and
inducements”, be renamed: “Items
for Patients, Promotional Aids, the
Provision of Medical and Educational
Goods and Services, Agreements to
Benefit Patients such as Joint Working,
Outcome Agreements and Patient
Access Schemes.”
PF-aug10-NEWS COMPLETE.indd 1
19/08/2010 13:20
Code set for
more changes
UK pharmaceutical companies will
have to declare exactly how much
money is spent on sponsoring and
paying consultants if new proposals are
agreed.
The Prescription Medicines Code
of Practice Authority (PMCPA) has
published a public consultation on its
second round of proposed amendments
to the ABPI Code of Practice.
Prolia
withdrawn
NICE has closed an appraisal of Prolia
(denosumab) for therapy-induced bone
loss in patients with nonmetastatic
prostate cancer after Amgen declined to
provide any clinical or cost effectiveness
data.
In a statement NICE said it had been
informed in August 2009 that Amgen
would not be making an evidence
submission. “Amgen stated that there
was a high volume of upcoming
NICE technology appraisals of Amgen
products and in order to ensure best
overall use of resources, it has decided
to focus its resources on other topics.
NICE has therefore terminated this
single technology appraisal,” it said.
Follow
PharmaField
on Twitter
GSK bonuses
decided by
customers
European
pharma braced
for squeeze
Customer feedback will play a central
role in deciding the bonuses that sales
representatives working at GSK’s US
subsidiary will receive, as part of a new
scheme to be implemented from 2011
onwards.
The company is implementing a
compensation system that will rely on
the customer service provided by the sales
professional, as well as adherence to the
company’s values of transparency, integrity,
respect and patient focus. It is part of a
wider effort on the part of GSK to better
target its sales staff based on the changing
needs of healthcare professionals (HCPs).
Pharma companies are bracing
themselves for further reductions on
drug prices across Europe.
CEOs fear the austerity measures
being introduced by governments
across the region are likely to lead to
increased pressure for lower-priced
medicines.
Shire to buy
Movetis
Specialist gastrointestinal (GI)
pharmaceutical company Movetis has
expanded its organisation into the UK.
The move coincides with Movetis
accepting an offer of €420 million from
Shire to buy the company.
Deirdre Connelly
Novo rejects
diabetes request
Novo Nordisk has turned down a
request to postpone the withdrawal date
of its insulin drug Mixtard 30.
Diabetes UK asked for a delayed
withdrawal to ensure a co-ordinated
response could be arranged and suitable
alternative treatments for patients found.
HAPPY IN THE
WORKPLACE?
HAVE YOUR SAY
UK COPD
treatment
launched
The first 24-hour long-acting
beta agonist (LABA) for the
treatment of COPD in adults
has been launched in the UK
by Novartis.
Onbrez Breezhaler
(indacaterol) is the first new
COPD treatment available in
the UK for eight years.
AUGUST 2010
GPs overprescribing
GPs have been over-prescribing
expensive treatments instead of
following NICE cost-effective
guidelines, a new National Prescribing
Centre (NCP) report says.
Findings show how GPs have issued
expensive drugs instead of cheaper
generic options, costing the NHS tens
of millions of pounds each year.
Reyataz
indicated for
HIV
HIV treatment Reyataz (atazanavir
sulfate) has been granted a paediatric
indication in the EU.
approved the boosted form of BristolMyers Squibbs’ drug to treat HIV-1
infection in paediatric patients aged
six to eighteen years and greater than
15kg, as part of combination HIV
therapy.
PAS not
working
Onerous paperwork could end up
costing the NHS millions of pounds in
missed reimbursements from patient
access schemes (PASs), a report has
claimed.
A study of 31 PCTs in England
showed more than 50% of the costs had
not been recovered on two of the first
four PASs – bortezomib and sunitinib.
Experience
NICE to
NICE backs
drives AF
review Vidaza
cancer drugs
recommendation NICE has recommended two new cancer guidance
A new treatment to reduce
mortality rates in patients with
atrial fibrillation (AF) has been
recommended by NICE, despite it
being less effective in preventing the
condition than existing options.
But sanofi-aventis’ Multaq
(dronedarone) can only be
considered as a treatment option
for patients who have additional
cardiovascular risk factors such as
diabetes or high blood pressure.
treatments in final guidance.
Roche’s Xeloda (capecitabine) has been
recommended in combination with a
platinum-based regimen for the first-line
treatment of inoperable advanced gastric
cancer. Iressa (gefitinib) has also been
given the go-ahead for first-line treatment
of locally advanced or metastatic nonsmall-cell lung cancer.
NICE is to re-appraise the use of
Vidaza (azacitidine) in patients
with higher-risk myelodysplastic
syndrome (MDS) – a group of
debilitating bone marrow diseases.
The decision follows months of
campaigning on the part of MDS
charities and patient groups.
NICE offers
more options
Hepatitis C patients are set to receive
more treatment options after NICE
updated part of its guidance on
the use of peginterferon alfa and
ribavirin.
New draft guidance reflects the
extension to the licensed indications
for peginterferon alfa.
NICE
relief for
Children
denied asthma constipation
treatment
A “pioneering” asthma drug for
children aged 6-11 has been rejected by
NICE in draft guidance.
The decision on Novartis’ Xolair
(omalizumab) came after tests showed
little benefit compared to existing
treatments and the lack of value for
money.
A new treatment for chronic
constipation for women could be on its
way to the UK after a 25 year wait.
Movetis’ Resolor (prucalopride) has
been recommended by NICE following
initial draft guidance.
A treatment for the most common
form of leukaemia in the UK has been
recommended by NICE.
MabThera (rituximab) will now
be available in combination with
chemotherapy drugs fludarabine and
cyclophosphamide for the treatment
of relapsed or refractory chronic
lymphocytic leukaemia.
Speers and
Turley to head
EMG
High NICE
pass rate
NICE has released figures showing it
has approved more than 80% of the
treatments it has reviewed since its
formation in 2000.
But the ABPI says that NICE could
do more to offer medicines “doctors
wished to prescribe”.
MabThera
recommended
The European Medicines Group
(EMG) has elected UCB Pharma’s
Managing Director Matthew Speers as
its new chair.
Speers takes over from Nigel
Brooksby (sanofi-aventis) and will
be supported by the new vice-chair,
Lundbeck Managing Director Steve
Turley.
Money
matters
Are the best things in life free? Not according to our recent survey amongst sales professionals in
pharma. So who is enjoying the best remuneration package? And which roles secured the best pay
increase over the last year? Diana Spencer reports.
S
alary was voted the most
important work motivator
out of 18 factors in the Pf
Company, Perception, Motivation and
Satisfaction Survey 2009. It was ranked
more important than your working
relationship with your manager, the
culture of the company you work for,
your work-life balance and job security.
Given the economic climate, it is
unsurprising that the average salary for
many people in the industry decreased
between 2008 and 2009 and that many
pharma sales professionals are less
happy with their remuneration than
they were a year ago.
But who has suffered most from the
wage cuts? And do age and gender have
an impact on the salary you receive?
Let’s take a closer look.
increase in both pay and bonus in 2009,
implying that these roles are increasing
in significance as account management
becomes the dominant sales model for
Show me the money
the industry.
The salary picture is quite varied across
After a slight boost to remuneration
different roles in the industry, but the
in 2008, those in representative roles
most notable feature of Figure 1 is the
(either both primary and secondary
drop in bonus rates across all job titles.
care or just primary) have experienced a
This decrease was especially significant
return to 2007 bonus and salary rates.
for healthcare development managers
When asked if they feel their
(HCD), after quite a dramatic boost to
their bonus rates in 2008. People in these remuneration is appropriate, the majority
have agreed that their wage is fair, though
roles have enjoyed a slight, but unusual,
increase in their basic salary, however, this still an average of around 40% feel they
are not getting just rewards for the work
could go some way to easing the pain of
they do.
lower bonus pay.
First line managers are one of the
The exception to the rule is key
least happy roles, and are significantly
account managers (KAM), who saw an
less satisfied than they were last year, no
doubt due to cuts to salary and bonus
rates. HCD managers are also feeling
under-appreciated, but their satisfaction
with their remuneration rate is still a
vast improvement on 2007. Hospital
specialists remain one of the happiest
roles in terms of the compensation they
receive.
Mind the gap
No discussion of industry salaries would
be complete without a quick look at that
age-old issue the ‘gender pay gap’. High
profile cases, such as the recent Novartis
trial in the US, have drawn attention
to discriminatory behavior in pharma,
demonstrating that perhaps gender bias
Figure 1: Remuneration by role
Primary role
Median salary
Median bonus
Remuneration appropriate?
2007
2008
2009
2007
2008
2009
2007
2008
2009
1st Line Sales Managers
£55,007
£56,000
£55,000
£8,000
£7,000
£6,000
67%
67%
59%
NHS Liaison/HCD
£45,000
£47,000
£48,200
£3,000
£6,000
£3,225
52%
59%
59%
Hospital Specialist
£42,000
£44,000
£43,000
£4,000
£5,000
£4,000
72%
74%
69%
Medical
Representatives
£32,000
£33,000
£32,000
£2,500
£3,330
£2,500
62%
64%
62%
Key Account
Manager
£40,900
£43,000
£44,000
£5,187.50
£4,150
£5,000
70%
58%
60%
22
Pharmaceutical Field August 2010
Figure 2: The value of experience
Age before beauty
Job role
Age group
Median salary (£)
Another topical area of
discrimination is that based
on a person’s age. Government
intentions to remove the
compulsory retirement age have
been both welcomed and criticised,
and the issue of ageism remains
a pertinent one for many. The
demographic of respondents to this
year’s survey imply that the UK
pharma sales industry is made up of
a relatively young workforce with
just 8% of respondents over 54
years of age.
Perhaps the more pertinent
age issues within the industry
are around how your level of
experience within the industry
impacts your salary and whether
you are discriminated against for
wishing to continue in a representative
role throughout your career, rather than
moving into sales force management.
An analysis of certain key roles by
age and salary indicates that experience
is certainly highly valued and rewarded
within pharma. However, those
wishing to stay within a representative
role for eight years or more can
only expect to earn an average of
£36,000, while someone who has
moved into first line management can
expect a salary of around £56,000.
Interestingly, every one of the first line
managers who responded to the survey
had more than four years experience
in the industry, demonstrating that
fast-track routes to management are
extremely rare.
Medical representative
>25
23,500
Tough times
25-34
29,600
35-44
34,000
45+
36,000
KAM
>25
N/A
KAM
25-34
40,500
KAM
35-44
45,500
KAM
45+
45,000
First line manager
>25
N/A
First line manager
25-34
50,400
First line manager
35-44
53,900
First line manager
45+
59,050
Job role
Years of experience
Median salary (£)
0 to 4
27,000
4 to 8
31,750
8 plus
36,000
KAM
0 to 4
28,000
KAM
4 to 8
40,000
KAM
8 plus
46,000
First line manager
0 to 4
N/A
First line manager
4 to 8
45,000
First line manager
8 plus
56,000
isn’t as dead as some would like to believe.
This is a complicated issue and
many factors could influence pay scales
for the different genders, however,
analysis of responses from the Pf Survey
does indicate a slightly higher average
salary for men in certain key roles. For
example, while the average salary for a
female sales representative is £32,000,
a man in a similar role is taking home
£34,000. This same £2,000 disparity is
also found in KAM roles and first line
management.
This is an interesting finding,
however, it is only with further
investigation into experience levels etc
that any discrimination could be proved.
The survey also revealed that of those
working reduced or part-time hours,
92% were women, and so it could be
that these reduced salaries are impacting
on the final result.
Figure 3: Salary in different age groups
With ever-increasing pressures on
our finances, mounting bills and the
cost of living soaring, how much you
earn is becoming more important
a question than ever. However,
many people appreciate that these
pressures are felt by businesses too,
even in an industry as secure as the
pharmaceutical industry. The boom
times, for both the industry and its
sales force, came crashing to an end
Quick Read
• Salary decreased between
2008-2009
• Bonus rates down
• Only key account
managers saw increase in
pay and bonus
• Majority agree wages
are fair
• Higher average salary for
men in key roles
• Experience highly valued
and rewarded within
pharma
with the large-scale redundancies that
took place at the start of this decade.
Now, as the decade draws
to a close, a new model for the
pharmaceutical industry is emerging.
With a shift in focus to account
management and partnership with the
NHS, every member of the pharma
field force needs to know their stuff
and know it well. It is hard to predict
what impact the events of the coming
year will have on the industry, but for
those prepared to meet this challenge,
the rewards could be great.
About the survey
The Pf Company Perception,
Motivation Satisfaction Survey has
been conducted annually by Health
Sector Publishing, publishers of Pf,
since 2002. It provides a benchmark
of field force remuneration,
motivation, satisfaction, perception
and recruitment. As the survey is
managed by Dr B Payne of Conker
Statistics (a fellow of the Royal
Statistical Society) and respondents
are anonymous, it is able to provide
a unique and impartial snapshot of
workforce attitudes at the time the
research is conducted. These latest
results were gathered in early 2010,
but relate to 2009.
The Pf Company Perception, Motivation and Satisfaction Survey has been
conducted annually by HSP, publishers of Pf, since 2002. It provides a
benchmark of field force remuneration, motivation, satisfaction, perception
and recruitment. As the survey is managed by Dr B Payne of Conker
Statistics (A fellow of the Royal Statistical Society) and respondents are
anonymous, it is able to provide a unique and impartial snapshot of
workforce attitudes at the time the research is
conducted. These latest results were gathered in
early 2010, but relate to 2009.
23
Seven steps
to boost
your
confidence
In modern society where everybody is judged
building or maintaining self-confidence levels can
be an almost impossible task. Here, Dr R K Powar
offers valuable ways to boost self-esteem at work.
T
he word confidence originates
from the Latin word confidere,
meaning to trust and to have faith
in. The original meaning of the word is to
have trust or faith in an object or person.
Confidence has many meanings for different
people, generally meaning certainty in one’s
world. Here are some other ideas.
•
•
•
A state of mind where one feels
sure about themselves and their
environment
The feeling of being secure and selfreliant
The feeling of optimism about things
in general
Therefore, it follows that self-confidence
means freedom from doubt and having
the belief in yourself and your abilities.
Whilst confidence is about feelings we
all at times have seen it in friends, idols,
managers, parents etc. At times we also
feel it and see it in ourselves, and some of
us more so than others. Also, it is worth
stressing that despite us at times seeing a
great deal of confidence in people they may
not necessarily be feeling confident inside
and, whilst confidence is not tangible, it is
contagious.
Developing self-confidence
The self-fulfilling prophecy: This is a false
definition of a situation in the beginning
evoking a new behaviour which makes
the original concept become true. If we
start with the premise that we will be
good at learning a new task, completing
a presentation or writing up a
report, this is what happens and
vice versa. There are times we have
admired presenters or broadcasters
for their confidence, but they
admit afterwards to being very
nervous prior to and during the
presentation. However, they have
succeeded in wearing the ‘selfconfidence outfit’. But what does
this outfit consist of?
Self-confidence is made up of
components such as being sure
about oneself. For example, being
competent, having the strength
to set goals and be disciplined
to achieve them, using failures
as learning opportunities and
identifying your successes and
using them to your advantage, to
name but a few. Recognising and
managing insecurities and ignoring
what others think are also important
components for building selfconfidence. Finally, one needs to
make sure the outfit fits the part in
terms of body language and speech.
Practise on being competent:
At a practical level it helps when
doing something for the first
time, or a task that might be
difficult, to break it down into
do-able segments. These will help
us stretch significantly to develop
but realistically enough so that we
can succeed. Each time we have
a success that will make us a little
more confident. After having a few
successes, the bar can be raised to
the next level.
Setting goals and using failures
as learning opportunities:
Setting goals helps to improve
our confidence because it gives us
direction. However, the goals must
be realistic and achieved within
a certain time framework. Each
time a goal is achieved we will get
motivated and can set the next
target. In cases where we have failed,
this will give us ample opportunity
to learn and grow. (See article on
The Learning Organisation: Is the
Pharma Industry willing to Learn?
April 2010)
Identify your successes: If we
reflect on the successes we have
had, this makes us feel good about
ourselves giving us positive energy.
Assured thoughts will help our
behaviour be positive giving us
our next ‘win’. In identifying our
successes it may become apparent
that the things we have had
successes in are things we enjoy
or are good at. Focusing on our
strengths will ensure more successes,
increasing our confidence further
and so on.
Recognising and managing your
insecurities and limitations:
None of us are perfect or good at
everything; therefore we need to
be realistic and also recognise our
insecurities and limitations. It is
also helpful to get the viewpoints
of some trusted friends and work
colleagues. Once we have a truthful
and holistic picture of ourselves we
can either decide to do something
or not about our insecurities and
limitations which promotes positive
thinking and actions.
Being competent,
setting goals and
achieving them,
learning from failures
and identifying
successes are all
components to build
self-confidence
Analyse your body language:
When we see people being
confident, the first thing we see
is their body language; and as we
know, first impressions have a major
impact on how we perceive people
and on how we are perceived. It
is therefore a good idea to pay
attention to our body language. If
one carries themselves confidently
that’s how they will feel, and in
turn, this is the image that is
projected to the outside world.
Confident people tend to have a
strong body language that exudes a
non-verbal presence.
Improve your image/speech: Our
body language is better when we are
dressed in attire that is suitable to
the situation. When we are dressed
smartly we feel good, our body
language is better making us more
confident. Speech also plays a part
in how confidently we are perceived
by others. A clear, well-paced
and enthusiastic speech, opposed
to a dull and monotone speech,
makes us feel more confident and,
subsequently, that’s how we are
perceived by others. As a result,
this makes us feel more confident
demonstrating the principles of the
Reinforcement Theory (Positive).
Confidence at work
An organisation’s success is
determined in many ways. There
is a plethora of methods in which
an organisation’s success can be
bettered. The employees of an
organisation are its greatest asset. A
positive, confident work force is of
paramount importance especially in
an organisation where the focus is
more on a service provision rather
than product provision.
In the pharmaceutical industry
a great deal of money and time is
spent and hard work is done behind
the scenes to get new drugs to the
forefront. With the combined skills
and expertise of various staff, the
drugs finally reach the endpoints,
i.e. the patients.
When several functions such as
product innovation, clinical trials,
medical affairs, marketing/branding,
training and sales team come
together it is crucially important
that each function has confidence in
each. One way or another this will
be apparent to customers.
For employees such as the sales
staff that have contact with external
customers, being confident is of
paramount importance. Initial
introductions will determine the
possibility of any future meetings
with customers and the likelihood
of their successes.
If sales staff see themselves as
confident people performing a very
important job, that’s how they will
be seen by the customers. If the sales
staff value their time the customers
will value the time of the sales staff
too. If the sales staff have confidence
in the products they are promoting
the customers are more likely to
perceive these in a positive light as
well.
Sales people in the pharmaceutical
industry provide medical
professionals and their colleagues
with invaluable knowledge,
Quick Read
• Not all people are as confident
as they suggest
• Set goals and learn from
mistakes to initially boost
esteem levels
• Increase targets after successful
periods
• Identify strengths and work
on them
• Decide whether to challenge
or ignore weaknesses or
insecurities
• Promote positive body
language
• Speak confidently and dress to
impress
developments in specialised
therapy areas and, whilst selling,
are equally providing a service with
their expertise. Sales teams that are
confident are also likely to be better
ambassadors for the industry too.
Contrary to popular believe selfconfidence is not something people
are born with. It is something that
can be developed as shown in this
article. There are no shortcuts to
increase one’s self-confidence as it
is a slow and steady process. Selfconfidence, similar to learning, is
ongoing and each time a person
has a positive experience their
confidence is made stronger.
Dr R K Powar has over ten years
experience in the pharmaceutical
industry and provides a range of
tailored programmes to develop
staff to help an organisation
improve on their Softer S’s skill
base. She can be contacted on
[email protected]
or 07962 342 140. For further
information visit
www.r11osyconsultants.co.uk
SEPTEMBER 2010
Prepare for partnership,
Chief Exec says
The NHS must look to develop “genuine
partnerships” if it is to maintain high
quality care within current resources, the
Chief Executive of the NHS has warned.
Sir David Nicholson has said that the
transition to the new system outlined
in the Government’s proposed reforms
should not be allowed to distract the NHS
from its major operational challenges, but
warned that the opportunities of the White
Paper would only be achieved by working
together more effectively.
Roche unveils
cost-cutting
plans
Roche has outlined cost-cutting plans
to increase its efficiencies in the US and
Europe.
The Group-wide Operational
Excellence initiative has been launched
to “adapt cost structures and accelerate
productivity” after recent developments
in Roche’s pipeline.
Severin Schwan
This is a
man’s world
p24
September 2010
NHS reform:
what it means
for pharma p15
Embracing
technology
p22
Prepare for partnership,
chief exec urges NHS
The NHS must look to develop ‘genuine
partnerships’ if it is to maintain high
quality care within current resources, the
Chief Executive of the NHS has warned.
Sir David Nicholson has said that the
transition to the new system outlined
in the Government’s proposed reforms
should not be allowed to distract the
NHS from its major operational challenges,
but warned that the opportunities of the
White Paper would only be achieved by
working together more effectively.
In a letter to senior NHS management
outlining how the service can manage
the transition, Nicholson said NHS
organisations must be prepared to work
not only with the proposed new public
health service, but also the independent
sector. “It will mean seeking genuine
partnerships rather than competing for
leadership space,” he said.
The communiqué acknowledged that
Government proposals are at consultation
stage and subject to change: “It is
important that we do not take binding
actions that prejudge the outcome of
the process.” However, he said the NHS
could not wait for all of the elements
of the new system to be in place before
proceeding. “We should make tangible
progress towards realising the principles
of Equity and Excellence as far as possible,
whilst not pre-empting consultation or
legislation.”
The move towards GP consortia
remains pivotal. Nicholson said GP
practices should be given time and
space to develop their plans to form
commissioning consortia, and that PCTs
should provide support to help consortia
take on new responsibilities. But, he said,
there was not a race to have the first or
the most GP consortia established or to
rush through unsustainable solutions.
“For commissioning, this is not about
dragooning GPs into administrative
boundaries that they do not feel any
allegiance with. It is certainly not about
replicating current structures with some
new players involved. The proposals
represent a fundamental change, not just
in structure, but in culture and ways of
working.”
The letter outlined how plans
and the bridging function have been
appointed.
Nicholson said the radical proposals
for changing the health and social
care system in the UK represented a
significant leadership challenge for the
NHS. Maintaining a strong grip on
current performance was, he said, central
to the success of the transition process.
Sir David Nicholson He identified four broad areas where
the NHS needs to focus to maintain
to establish national leads for
control of quality and finance during the
commissioning and provision, and to
transition. These were; the QIPP agenda,
split commissioning from provision
rising emergency activity, preparation
at national and regional level whilst
maintaining a bridging function during for winter emergency activity, and
commitment to maintain the maximum
the transition, have progressed. Leads
18-week time between referral and
at regional level for commissioning
treatment.
development, provider development
Difficult month for UK pharma giants
Two of UK pharma’s biggest
players have endured a tough
September. GSK and AstraZeneca
have each received adverse press
coverage, with GSK facing
increased concerns over its
diabetes blockbuster, Avandia,
and AstraZeneca battling a staff
revolt after employees at its site in
Macclesfield voted to strike over
changes to pension benefits.
The MHRA has said that
Avandia “no longer has a place on
the UK market” while the BMJ has
called for it to be suspended. But
GSK is defending its data (p6).
AZ said that only 165 of its UK
employees – less than 2% – voted
to strike. But the GMB says AZ’s
proposals are “draconian” (p2).
PF-SEPT-NEWS COMPLETE - Amends IB.indd 1
Novo Nordisk
launches ‘app’
A UK charitable trust is taking Cimzia’s
manufacturer UCB to court for promoting the drug in combination with
methotrexate.
The Mathilda and Terence Kennedy
Institute of Rheumatology Trust filed
the case against Belgian company
UCB for infringing its 2001 patent
on combining drugs like Cimzia with
methotrexate.
The first-ever mobile insulin dosing
guide for use with the iPhone has been
launched by Novo Nordisk in the US.
NovoDose is available as an
application on iTunes for US
healthcare professionals and is specific
to Novo Nordisk’s Levemir and
NovoLog insulin products.
15/09/2010 12:15
AZ staff strike
AstraZeneca staff (AZ) have gone
on strike in protest over changes to
pension benefits.
Seven out of ten employees at AZ’s
site in Macclesfield voted to take
action over what the GMB called
“draconian proposals to, in effect,
end its final salary pension scheme
for 2,500 staff”.
Calls for
Avandia
withdrawal
Experts have called for a complete
withdrawal in the UK of GSK’s
diabetes drug Avandia (rosiglitazone).
The MHRA said “it no longer has
a place on the UK market”, while
the BMJ called for Avandia to be
suspended and insisted it shouldn’t
have been licensed at all.
Pharma
turning to
hired help
Pharmaceutical companies are
turning to contractors instead of
full-time employees, new data
suggests.
The Global Life Science Hiring
Index shows that 15% of sales
and marketing positions are now
outsourced across Europe, the
Middle East and Africa.
UK charity
sues UCB
US pharma
sales calls
drop
The number of sales calls made by
the pharma industry to US health
professionals dropped in the first half of
2010.
Overall, in the US, sales calls to
practitioners decreased 1% in the first
half of 2010 compared with the previous
six months, according to a study by SDI.
Trio breach
ABPI code
Three pharma companies have
breached the ABPI’s Code of Practice.
The PMCPA ruled that
ProStrakan Group plc, Cephalon
UK and GlaxoSmithKline Consumer
Healthcare had breached Clause 2
of the Code – bringing discredit
upon and reducing confidence in the
pharmaceutical industry.
Study assesses
rep quality
Sales representatives from Wyeth,
Novartis and Recordati have
outperformed their European
competitors in a recent international
study of rep quality.
The Rep Quality Survey, conducted by
Cegedim Strategic Data (CSD), aimed to
benchmark representatives’ performance
in the emerging markets of Brazil, Russia,
India and China against the top-five
Eurpoean markets, the US and Japan.
Gyllenhaal to
play sales rep
Follow
PharmaField
on Twitter
A romantic comedy based on a
2005 autobiographical exposé of
the pharmaceutical industry is to be
released in UK cinemas this December.
Love and Other Drugs, starring
Jake Gyllenhaal and Anne Hathaway,
is loosely based on Jamie Reidy’s ‘kiss
and tell’ account of selling Viagra
for Pfizer, published in March 2005,
Hard Sell: The Evolution of a Viagra
Salesman.
SEPTEMBER 2010
Innovative pain MDD
spray approved treatment
approved
approved a new nasal spray treatment
for breakthrough cancer pain (BTCP)
that has been proven to provide relief
within 10 minutes.
Archimedes Pharma’s PecFent, an
innovative fentanyl nasal spray, has
been granted a marketing authorisation
to treat BTCP in adults who are already
receiving maintenance opioid therapy
for their chronic cancer pain.
AstraZeneca’s Seroquel XR has been
given a positive decision by the
EC for use in patients with major
depressive disorder (MDD) who
have not responded to antidepressant
monotherapy.
The decision from the EC follows
a similar recommendation from the
FDA in the US.
Vaccine under
review
GSK’s swine flu vaccine Pandemrix
is to be reviewed by the European
Medicine Agency (EMA) on the
request of the European Commission.
The investigation will study whether
there is a link between cases of
narcolepsy and the vaccination after a
number of reported instances, mainly
in Sweden and Finland.
Brinavess
secures EU
approval
The first new medicine for recent onset
atrial fibrillation (AF) in more than a
decade has been approved for use in
Europe.
The intravenous (IV) formulation of
Brinavess (vernakalant) has been given
the green light in the EU, Iceland and
Norway for the conversion of recent
onset atrial fibrillation to sinus rhythm
in adults.
NICE reverse
backed
NICE under
fire over
Avastin
Thousands of rheumatoid arthritis (RA)
sufferers are set to benefit from two new
pieces of guidance after NICE reversed
an earlier appraisal.
NICE has now recommended
MabThera (rituximab), Humira
(adalimumab), Enbrel (etanercept),
Remicade (infliximab) and Orencia
(abatacept) as treatment options for
RA. In separate guidance, RoActemra
(tocilizumab) was also given the green
light.
NICE has come under attack following
its decision not to recommend bowel
cancer drug Avastin.
The independent Appraisal
Committee considered the treatment
too expensive and questioned Roche’s
calculations on a proposed Patient
Access Scheme.
Drug uptake
reported
NHS organisations will be named for the
first time in a report by NICE on their
uptake of positively appraised drugs in
England.
The report, set to focus on SHAs,
PCTs or cancer network levels, will
include data depending on the level of
usage and healthcare settings.
NICE unable
to recommend
Glivec
NICE has said that a lack of clinical
evidence has made it unable to
recommend Novartis’ Glivec (imatinib)
as a treatment for the recurrence
of gastrointestinal stromal tumour
(GIST).
The Appraisal Committee said that
whilst Glivec after surgery, as adjuvant
therapy, could delay the recurrence of
GIST, concerns over key aspects of the
drug’s clinical effectiveness contributed
to the decision.
UNISON to
take DH to
court
UNISON, the UK’s largest public
service union, has started legal action
against the Secretary of State for
Health as part of a campaign to save
the NHS.
The union claims that the
Government’s refusal to consult the
public on the proposals in its White
Paper, Equity and Excellence: Liberating
the NHS, is unlawful and “lip service
of the worst kind”.
PBC costs
millions
Practice based commissioning (PBC)
has cost hundreds of millions more
than it has generated in savings, an
investigation by Pulse has found.
The analysis of PBC since its
inception in 2005 found that GPs
will take on budgets faced by a hugely
uneven playing field, depending on
whether GP commissioning has become
established in the local health economy.
Victoza secures
BMA issues
restricted
commissioning
recommendation
guidance
NICE has recommended Novo
Nordisk’s diabetes treatment Victoza
(liraglutide), but restricted its use.
In draft guidance, NICE
recommended Victoza 1.2mg daily
dosage in combination with metformin
or a sulphonylurea if treatment with
metformin or a sulphonylurea, and
thiazolidinediones and dipeptidyl
peptidase-4 (DPP-4) inhibitors are
unsuitable.
The BMA’s GPs Committee has
outlined what it believes should be the
fundamental principles underlying the
development of GP commissioning.
The GPC’s first position statement
on GP commissioning since the
publication of the White Paper says
that these principles should be used
to “define policy, inform debate and
negotiations, and ensure that good
medical practice is enshrined within
the changes proposed in Liberating the
NHS”.
The proposed White Paper reforms offer pharma companies the perfect opportunity to
evolve and introduce new commercial strategies. Calling upon his own experiences, Adam
Knights explains how the role of Key Account Managers can help pharma change the record
I
had a smile like the Joker from
Batman when I first read the
White Paper. It is not every day
that Government agenda falls in line
with your business strategy but on July
12th that’s exactly what happened to
us at 15 Healthcare. Since we started
the company in 2009, my fellow
directors and I have championed
one fundamental maxim to enable
success: the only way to manage NHS
customers is by deploying key account
management strategies that ensure
company personnel are in front of the
right person at the right time in order
to broker business to business deals.
The White Paper is not so easy for
the pharmaceutical industry though.
How much time, effort and money
has the industry spent dealing with
medicine management mandarins;
whose agenda has been about limiting
effective branded medicine on the basis
of cost? This customer cohort will likely
dissipate from PCTs to compete for
roles within emerging GP consortia.
The question is, as customers move
around amidst organisational upheaval,
where should the industry focus its
efforts? Who will the market access
team deal with in the future? Where
exactly will decisions be made? Whilst
the White Paper heralds radical reform
and change for the NHS, will the
industry be prepared to embark upon
such disruption in order to align more
effectively with its customers?
A new era
The NHS has undergone many
changes over the years. However the
White Papers signals perhaps the most
radical in the last 25-years. Whilst we
await further details we know that that
GP consortia will form and will most
likely become home to a number of
functions hitherto provided by PCTs.
Pharma will need to react and adapt to
interact with these emerging customer
groups. Imagine a consortium of
150,000 patients with the power
to commission services, procure
medicines and manage prescribing
without any interference from a PCT?
The idea of calling on individual
GPs with a ‘sales aid’ and the ‘latest
campaign’ will become redundant.
The industry talks a lot about
Key Account Management yet most
companies only tinker at the edges.
Sending someone on a two-day KAM
course and giving them a new title
will not give them the commercial/
clinical nous they will need in the new
world. New skills, competencies and
frameworks will have to be drawn up
to deal with a variety of customers
ranging from commissioning leads to
finance directors. That doesn’t mean
just retraining the sales force, it means
every aspect of the business needs to
understand the new world.
Medical departments will have to find
ways to support these functions and
resist becoming totally risk averse. Key
Account Management is about telling
your teams what they can instead of
what they cannot do.
Internal training and development
teams will need to raise their game
too. No more cuddly marshmallow
attendance courses with everyone
‘loving’ the trainer at the end. My guess
is the new level of training will come
externally initially until the bar is raised
internally. I have seen lots of courses
running that don’t resemble anything
like the environment the sales force are
facing. Keep it real and accept it will be
painful for some.
Working together
For me the next phase of Key Account
Management is alignment - both
external and internal. Let's assume that
your sales force has become an effective
group of account managers. Now ask
yourself the question: are we aligned?
Does every department understand
the overall strategy? Does the strategy
allow a bottom up process and, most
importantly, is the strategy aligned with
that of the NHS (See Figure 1).
Culture and processes is the single
biggest challenge, companies that
manage this well excel. Those who
don’t struggle to succeed with any
organisational change.
Pharmaceutical Field September 2010
•
I have heard mutterings from some individuals
that the White Paper will allow them to go back
to the old way of working and coverage and
frequency models will come back into vogue.
Please do not be so naive to think that this will
accelerate your organisation to success
Businesses can assess their
commercial effectiveness through
alignment. Not being aligned costs
money. Some simple and effective
measures will increase productivity.
I have heard mutterings from some
individuals that the White Paper will
allow them to go back to the old way
of working and coverage and frequency
models will come back into vogue.
Please do not be so naive to think that
this will accelerate your organisation to
success. Teams comprising of capable
account managers will gain ground
with customers as GP commissioners
seek to secure value-based clinical and
commercial deals.
•
Autonomy: people used to
autonomy thrive in a KAM
environment. With autonomy
comes responsibility however, it
also means making some mistakes
– you cannot build a first class
account team without making
errors, its normal!
Sales focused: all these
competencies are fine but useless
unless you can deliver on sales.
Professional account managers like
to be held responsible for sales.
Are account teams working the same
locality successful? In my experience,
no. This is because the key to KAM is
to deploy an individual who becomes
the centre of every activity in a specific
geography. This person ideally should
be accountable for the profitability of
Commercial acumen: can this
the business and report at a board level.
person deliver on a commercial
Other support functions like medical
deal and, more importantly, can
liaison and marketing should satellite
they recognise one when it is
this individual and be deployed as an
staring them in the face.
Strategic planning: is the account appropriate resource when needed.
Many companies fail to resist
plan strategic? Does it align with
the local NHS? Does the account the temptation to establish a team
of account managers on the same
manager fully understand the
territory and then add insult to injury
business planning process?
by introducing a RBM to manage
Compelling argumentation:
them. Where is the accountability in
when challenged by a customer
this model? By default it is the RBM.
can the account manager
By adding a regional boss to the mix
deal with the issue there and
you immediately create a further
then without having to refer
management tier that clouds effective
simple questions to a medical
‘line of sight’ on the business. I was an
department?
purpose. How should companies assess
capability, skills and competencies?
Some of the competencies 15
Healthcare look for include:
•
•
•
The case for Key Account
Managers
The KAM approach works provided
the individuals in role are fit for
Figure 1
Pharma internal challenge: KAM is both your biggest commercial opportunity and your biggest threat
 Most pharma companies failed in changing their business model from traditional to KAM
 Most pharma companies failed in successfully restructuring their sales force after ignoring drivers that will change
their KAM behaviour in the field: culture and processes
Evaluating KAM restructuring effort
Key Success Factors
Importance
Company
Rationale
Structure
20%

Key account Team per territory
People
30%

Same people in same territory supposed
to do a different job post - restructure
Culture and
processes
50%
!
Setting the right environment for the
field force to work the way you want
them to work
Manage the culture and the culture will manage your people
Quick Read
•
•
•
•
Pharma needs to react
and adapt to interact
with the new emerging
customer groups
Every department needs
to understand the new
NHS and be aligned in
order to succeed
KAMs need realistic
training to be
successful
Pharma should opt for
KAM model instead of
account teams overseen
by RBMs
RBM at one point in my career and,
in all honesty, I got in the way. I was
so concerned with delivering inputs
for the senior management team that
the real business did not receive the
time or exposure it needed and, as a
consequence, did not grow. The RBM is
one of the toughest roles in the industry.
Managing the business, appeasing
senior management and keeping a team
happy whilst getting a knife in your
back every 10-minutes is no fun. It is a
role that many aspire to and often regret
within six months of being appointed.
The question that has to be asked
by all companies is clear: amidst so
many changes affecting our customer
organisations, and where a move
towards advanced account management
seems a logical progression, are RBMs
really needed? If the RBM is that
capable – and many are – at business
skills, coaching, mentoring, leadership
and selling, why not make the RBM the
Key Account Manager? After all, there
is no written rule that states all sales
models have to conform to traditional
norms.
Adam Knights is Managing Director
of 15 Healthcare – a leading
healthcare broker between the NHS
and pharma through holistic and
strategic key account management.
Adam joined the pharmaceutical
industry in 1998 after a successful
career in the armed forces. He
applied military strategy and tactics
early on to develop an account model
that challenged traditional thinking
and planning. He went on to pilot
successfully the regional account
director (RAD) in Takeda before
becoming the first RAD in the
UK and then sales director for
the RAD team.
This is a
man’s world
Whether in the playground or the boardroom the question of gender supremacy always
causes heated debate. Using Pf’s Company Perception, Motivation and Satisfaction Survey,
Iain Bate highlights some interesting differences between the sexes.
T
he recent cases in the US
against two of the pharma
industry’s major players
has seen the ugly issue of gender
discrimination dragged through the
courts once again. Since the 1970s
when the Equal Pay Act and the Sex
Discrimination Act were introduced
in the UK great strides have been
made towards equality. However the
US court cases have clearly shown
that despite all the laws in place both
here and across the pond gender
discrimination is still alive and kicking.
In the pharmaceutical industry
it’s clear that women are fighting
back this trend. A growing number
of women now hold presidential or
vice-presidential positions in various
capacities in many high profile
organisations. In the age of equality,
this should come as no surprise.
However, two main issues continue to
bedevil the battle for a level playing
field; does sexual equality extend to
company pay structures? And, the
age-old debate – who makes the better
boss: man or woman?
Sex(ist) Machine
A study by UK recruitment firm www.
ukjobs.net showed that two-thirds
of women agreed that men make
“stereotyping happens
almost from day one
where girls are dressed
in pink and boys in
blue. There’s very deep
seated assumptions and
stereotyping which
goes on.”
better bosses. Female managers being
hormonal, talking behind employees’
backs and an inability to leave personal
issues at home were all main factors
in the conclusion. Yet in America it’s
the other way round for Carol Smith,
Senior Vice President and Chief Brand
Officer for the Elle Group.
“Hands down women are better.
There’s no contest,” she said in an
interview with the New York Times.
“In my experience, female bosses tend
to be better managers, better advisers,
mentors, rational thinkers.”
This isn’t a view necessarily shared by
Charlotte Rayner, Professor of Human
Resource Management, Portsmouth
Business School, who argues that both
males and females boast attributes
which contribute to the age-old
argument.
“There’s no reason why men or
women should be better bosses,” said
Professor Rayner. “This is an area of
ordinary human skill and competence
and both genders should be able to
perform just as well as each other.
A man making a better boss than
a woman is a matter of perception.
Throughout all of history it’s often
been the case that men have been
profiled as the major leaders and it
could be that we still perceive men as
the archetype for those sorts of roles.
“This perception results very much
from stereotyping which happens
almost from day one where girls are
dressed in pink and boys in blue.
There’s very deep seated assumptions
and stereotyping which goes on.”
While it may seem obvious that
gender stereotyping involves males and
females the reality may be that women
are hindering the progress of other
women in the workplace due to these
long standing judgements.
“In the studies I’ve been involved
in we continually look for gender
differences,” Professor Raynor added.
“We ask people what experiences
they have had in the workplace. This
includes gossip and rumour and we
continually find no differences between
males and females. But what might be
happening, for example, is that when a
woman boss talks behind somebody’s
back it’s gossip, but when a man does
the same thing it’s then rumour. From
a male boss perceptive it could also
be seen that he’s asserting his position
and working through the politics.
Whereas a woman might be seen to be
undermining and gossiping and that
all comes back to basic stereotyping.
It’s exactly the same behaviour but
what we do is label it differently.”
Payback
The main bone of gender contention
relates to pay. The debate appears
to plague every industry – and
pharma is no exception. The Pf
Company Perception, Motivation and
Satisfaction Survey includes a detailed
section on remuneration. As ever, the
2009/10 poll provides some interesting
insights – not least to the gender
debate. Completed by more than
1,200 employees from UK pharma
sales, 53% of which were women, it
Pharmaceutical Field September2010
Quick Read
•
•
•
•
•
•
•
•
•
Great strides made in equality
since 1970s
No reason why men or women
make better bosses
Long standing assumptions and
stereotyping continues
Men earn more than £1,500 on
median average salaries
Generally, pay gap is decreasing
Pharma industry attractive to
women employees
Women more satisfied with pay
than men
Maternity and paternity leave
causes problems
Equality improving, but still long
way to go
Figure 1
2010 median salaries (full-time employees)
Job title
Male
Female
Medical representatives
£34,500
£32,060
Hospital specialist
£44,000
£42,400
NHS liaison
£49,000
£46,885
1st line manager
£55,000
£55,000
Figure 2
Combined median salaries*
Year
Male
Female
Difference
2006
£41,027
£39,125
£1,899
2007
£41,000
£40,150
£850
2008
£45,200
£44, 288
£912
2009
£46,500
£43,840
£2,660
2010
£45,625
£44,086
£1,539
*figures combine median salaries of medical representatives, hospital
specialists, NHS liaison officers and 1st line managers.
revealed some interesting statistics
when comparing individual (figure 1)
and overall salaries (figure 2), and also
motivational factors between men and
women.
When the median salaries are
scrutinised by gender, and combined
across all the standard sales roles,
the Survey reveals that the average
median salaries for men in 2009/10
was £1,539 more than women. Only
four years earlier the difference in
median salaries was just £850. The
latest Survey figure does however show
an improvement of more than £1,000
from 2008/09.
Despite the existing gap Professor
Raynor says salary divide could have
more to do with men being more
willing to ask their superiors for a wage
increase rather than companies trying
to scam females out of thousands of
pounds each year.
“It’s quite often that men are more
assertive in this area by often asking
for pay rises,” she said. “But sometimes
women are not pushing their own
pay claims as much as they might.
My advice to women in terms of pay
would be to think like a man!
“Generally the pay gap is getting
smaller. What has been very helpful
around the country, and certainly in
the private sector, is there are much
better job descriptions being produced
and better human resources processes.
Companies are assessing what a job is
worth and not what a person is. People
are being much clearer that they’re
paying for a job and not a person.”
Get on the good foot
The UK pharmaceutical industry
remains an attractive one for women.
Of the respondents in this year’s survey
70% who had less than six month’s
experience in the industry were female.
While this high number suggests
a career in pharma is appealing to
women, that fact that half of those with
more than eight years of experience
were also female confirms this.
In fact, despite the salary gap in
certain roles, results from the Survey
indicate that women are more satisfied
with their annual wage than their
male counterparts. More than half of
women revealed they were happy with
their wage packet at the end of the
month compared with 46% of men.
This continues an annual trend with
the Pf Survey.
Papa’s got a brand new bag
Across all industries, data suggests that
women still feel uneasy about stepping
Figure 3
Top-five 2010 motivational factors
Men
Women
1. Salary
1. Salary
2. Relationship with manager
2. Work-life balance
3. Work-life balance
3. Relationship with manager
4. Job security
4. Belief in products
5. Company culture
5. Company culture
off the career ladder to start a family.
But Professor Raynor says this unease
at switching from a business woman
with responsibilities to a housewife
with children is not solely reserved
for females.
“We’re seeing more women
deciding not to have children and
taking the career route because they
look around and see it’s difficult to
combine career and children,” she
continued. “Although I feel that
men experience this as well. When
children come along, their focus on
why they’re at work starts to change.
It’s very good to start to see paternity
leave come in. In many ways what
we’re talking about now could be an
end to those stereotypes. Actually,
males have a hard time too but we
16
hardly ever talk about this.”
Although men might not suffer as
much in the pay stakes as women do
when children come along there are
a number of decisions which can ease
the process, especially for women.
Those leaving a career to start a family
are encouraged to set their priorities
early; get the support needed from
their family required to balance the
long hours and added work load; to
decide from the outset what is right
for them personally and consider the
implications in the long term.
I feel good
Professor Raynor says the equality
divide which still exists today is still
some way from being eradicated
where work and pay is concerned.
But the more women in positions of
power the more likely it is they will
break down the barriers and we’ll see
the balance and fairness suggested in
the soon to be implemented Equality
Act 2010.
“We are still a long way from
gender equality that a lot of people
would want,” she concludes. “For
males it’s the balance between
paternity rights and a career. For
women it’s pay, maternity rights and
a career. Things are changing though.
Women in senior positions are seen as
role models for other women working
within the organisation. Other
women look and say ‘if she can do it
then so can I’.
“This also applies to people who
take career breaks and who are still
able to succeed. It would be very
positive if we had more leeway
for paternity leave and a positive
attitude from society about a genuine
openness about men and women
switching the caring roles in the
home.”
Although in the Survey both sexes
agreed that salary was the main
motivational factor (figure 3) at
work, responses from women showed
that work-life balance was more
important than their relationship
with their boss. A trend reversed in
men. The link between relationship
with manager and job security for
men suggests that keeping the boss
sweet in order to maintain in work
Quick Read
• Great strides made in
equality since 1970s
• No reason why men or
women make better bosses
• Long standing
assumptions and
stereotyping continues
• Men earn more than
£1,500 on median average
salaries
• Generally, pay gap is
decreasing
• Pharma industry attractive
to women employees
• Women more satisfied with
pay than men
• Maternity and paternity
leave causes problems
• Equality improving, but
still a long way to go
during a period of recession is far
more important than it is for women
– who consider the balance between
being at work and spending time
with the family more important.
Whether or not the age-old
argument of who makes the better
boss will ever be agreed, or whether
true equality in the pay stakes will
ever be resolved remains to be seen.
However, as the motivational factors
in the Pf Survey show, it’s still
obvious that where work is concerned
men come from Mars and women
come from Venus.
Pharmaceutical Field September2010
OCTOBER 2010
Plans may threaten patient
care
The Royal College of General
Practitioners (RCGP) has become the
latest professional body to question the
scale and pace of change proposed in the
Government’s White Paper for the NHS.
The College’s official response to
the proposals broadly backed many
of the policies, but expressed concern
that the scale of change required
was “not justifiable in the context
of cost reductions” and could prove
“disruptive”.
October 2010
The perfect
outcome?
Life’s a
beach
A new
direction
p15
p29
p24
‘Disruptive’ plans could
threaten patient care
The Royal College of General
Practitioners (RCGP) has become the
latest professional body to question
the scale and pace of change proposed
in the Government’s White Paper for
the NHS.
The College’s official response to
the proposals broadly backed many
of the policies, but expressed concern
that the scale of change required
was “not justifiable in the context
of cost reductions” and could prove
“disruptive”.
The comments echo the views of
the Royal College of Nursing (RCN)
who have said that the proposals sit
within a highly ambitious timescale
and present considerable risks to
services at a time when the NHS
is striving to make £20 billion of
efficiency savings.
Health Secretary Andrew Lansley
defended the proposed speed of
change. “The timetable is ambitious,
but it is not a timetable which is
unachievable,” he said. “With twoand-a-half years with which to learn
from pathfinder commissioning
consortia and establish shadow
arrangements, there is ample time for
practices that do not yet feel ready, to
secure capability collectively.
“These reforms give GPs the
overall responsibility for the design
Ex-TUC man is
new Shadow
Health Secretary
John Healey, former housing
minister and a member of Gordon
Brown’s cabinet, has been named
as the new Shadow Health
Secretary. Healey, who takes over
from former health secretary
Andy Burnham, was Campaigns
Director for the TUC from 1994
to 1997. Labour is now poised
to fiercely campaign against
PF-OCT-NEWS.indd - Edit IB.indd 1
Andrew Lansley’s proposals for
the NHS. “The Government’s
plans will damage care for patients
and dismantle the NHS as our
national health service,” he said.
“I look forward to working with
Ed Miliband to show clearly
and quickly what the Tory plans
will mean for people and their
families.”
of services, which meet their patients’
needs, and facilitate a quick response
when failures in those services arise.”
RCN welcomed the principles
behind the reforms and endorsed the
focus on outcomes, choice, patient
involvement, professional freedom
and the removal of unnecessary
bureaucracy. But it warned that
“untested proposals” could have a
negative impact on patient care and
urged the Government to pilot and
evaluate its proposals before they are
implemented.
The RCGP gave its backing to the
principle of ‘shared decision-making
with patients’, but reiterated its
opposition to giving patients freedom
to choose their GP. This policy could,
it said, be “very damaging in terms of
continuity of care, health inequalities
and potentially patient safety”.
The comments were the latest in
a series of official responses to the
White Paper that emerged as the
consultation process entered its final
days. The most high-profile critique
was issued last month by the BMA,
who warned that positive elements of
the proposals could be at risk from
other aspects that “seek to accelerate a
market-based approach”.
The Association said it was
concerned that attempts to encourage
competition in the NHS would risk
shifting the focus on to cost rather
Andrew Lansley
than quality and could undermine
opportunities to work collaboratively
across primary and secondary care.
Dr Hamish Meldrum, Chairman
of Council at the BMA, said that
“pitting clinicians against each other
in a market-based system creates
waste, bureaucracy and inefficiency”.
The BMA said plans to hand
commissioning responsibilities to
GP consortia will only succeed if
other clinicians are brought into
the process. It said GPs, secondary
and tertiary care consultants, public
health consultants and clinical
academics must all collaborate to
ensure commissioning is effective.
RCN said the reforms would struggle
without harnessing nursing leadership
and expertise at all levels of the
commissioning process.
Abbott to cut
jobs
Tesco has become the first
supermarket chain to sell antiimpotence drug Viagra direct to
customers.
Following similar over-the-counter
rules used by Boots, the supermarket
giant is expected to start a price war
by selling eight tables for £52.
Abbott is to cut 3,000 jobs, many
of which will affect Solvay workers
following Abbott’s acquisition of the
company’s pharmaceuticals business.
The planned cuts represent 3% of
the combined companies’ workforce
of around 93,000 and will affect
all departments in both the US
and Europe, a spokesperson for the
company has said.
BMS latest to
cut jobs
Unite has launched a campaign
opposing the proposed NHS
reforms in the White Paper.
The union said the proposals had
“no democratic mandate” and would
begin “the rapid privatisation of the
health service”. The Unite 4 our
NHS campaign opposes the White
Paper and the cuts being inflicted on
the health service among its 100,000
health sector members.
Roche’s primary care sales force is to
be the focus of cost-cutting efforts,
following problems with a new diabetes
treatment, CEO Severin Schwan has
revealed.
Schwan told Reuters that the
primary care sales force would be one
area that was looked at as part of a new
efficiency drive announced last month.
13/10/2010 13:24
Tesco to start
price war
Unite
contests
reforms
Roche’s sales
force under
review
Bristol-Myers Squibb has become the
latest company to announce job cuts,
with the revelation that it is to reduce
its workforce by around 3%.
The loss of around 840 jobs over the
next six-months will be in addition to
the 7,000 jobs cut by the company last
year.
HAPPY IN THE
WORKPLACE?
HAVE YOUR SAY
Severin Schwan
Gilenya set for
sales rocket
Novartis can expect blockbuster sales
for its multiple sclerosis (MS) treatment
Gilenya (fingolimod), according to
Datamonitor.
The convenient treatment is the
first of a new generation of MS disease
modifying therapies addressing key
unmet needs of oral administration and
increased efficacy.
EMA and FDA
extend pact
(EMA) and US Food and Drug
Administration (FDA) have extended
their confidentiality agreement
indefinitely.
The deal between the regulatory
bodies allows the pair to share
information on issues related to
medicinal products for human and
veterinary use.
Merck KGaA
vows to fight
decision
Merck KGaA has vowed to get
Cladribine Tablets approved in Europe
after the CHMP issued a negative
opinion for a marketing authorisation
application (MMA).
The Committee said that it was unable
to offer an MMA due to the benefits of
the multiple sclerosis (MS) treatment not
outweighing its risks.
To read the full
story, click on
the headline
Seroquel XL gets UK OK
AstraZeneca has secured
UK approval for Seroquel
XL (quetiapine prolonged
release) as an add-on
treatment for major
depressive episodes.
The drug is indicated
in patients with Major
Depressive Disorder
(MDD) who have not
responded to antidepressant
monotherapy.
OCTOBER 2010
200 not out
New cancer
strategy revealed for NICE
The Government has outlined new
plans which it claims could save the
lives of up to 10,000 cancer patients
each year.
The cancer strategy will see
substantial investment in five main
areas, including boosting the number
of specialists and raising cancer
awareness, to increase survival rates.
NICE has completed its 200th
technology appraisal.
The landmark figure was reached
with the publication of updated
guidance for the treatment of
chronic hepatitis C. More than
four-fifths (83%) of NICE’s 397
decisions to date have been positive,
with only 52 treatments failing to be
recommended.
Herceptin
U-turn by
NICE
Roche’s cancer drug Herceptin
(trastuzumab) will soon be available
to treat NHS patients with gastric
cancer, after NICE reversed its
previous negative recommendation.
The Institute has recommended
the drug for patients with metastatic
gastric cancer who have high levels
of human epidermal growth factor
receptor 2 (HER2), a protein found
on the surface of some cancer cells.
Thousands of NHS staff are paid more
than the Prime Minister, an investigation
has found.
The NHS has 26,000 staff earning
more than 100k a year with nearly
6,500 employees paid more than David
Cameron’s £142,500 salary.
New CQC
chair
Amgen’s Prolia (denosumab) has been
recommended by NICE for postmenopausal
women who are at increased risk of
osteoporotic fractures in draft guidance.
Prolia is to be used if treatment with oral
bisphosphonates alendronate, and either
risedronate or etidronate is unsuitable.
NICE says the recommendation is a
“useful additional” to treatment options for
women. Final guidance is expected later in
the year.
The Health Committee has
endorsed the Government’s proposal
to appoint Dame Jo Williams as
the new chair of the Care Quality
Commission (CQC).
In details submitted as part of the
candidate suitability process Dame
Williams outlined a number of
priority challenges which matched
the Committee’s views.
NICE updates
hep C
guidance
Sir Andrew Dillon
First GP
consortia
launched
The UK’s first GP consortia have been
launched in Cambridgeshire.
The two consortia will have control
of all commissioning in their areas
and have access to a budget of around
£215 million. However, the PCT
will still have to approve spending
decisions until the Government
changes the current legislation.
Thousands
earn more
than PM
Prolia gets
draft OK
NICE says no
to Yondelis
NICE has again failed to
recommended ovarian cancer drug
Yondelis (trabectedin) in its latest draft
guidance.
The decision, following a failed
appraisal earlier this year, followed a
lack of clinical data and concerns over
the drug’s effectiveness compared with
the most commonly-used treatment.
NICE has updated guidance on
the use of Pegasys or ViraferonPeg
(peginterferon alfa 2a or 2b) and
Copegus/Rebetol (ribavirin) for the
treatment of chronic hepatitis C.
The decision follows changes in the
marketing authorisations for Pegasys
and ViraferonPeg and recommends
their wider use, and, where appropriate,
shorter treatment durations for adults.
Gilvec fails to
get backing
NICE has been unable to recommend
the use of Glivec at increased
levels (imatinib) to treat metastatic
gastrointestinal stromal tumours (GIST)
in its latest draft guidance.
The decision relates to doses of 600
or 800 mg/day for people whose disease
has progressed after treatment with a
reduced use of the drug.
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PharmaField
on Twitter
Dame Jo Williams
New DH
secretary
Una O’Brien has been appointed as
the new Permanent Secretary for the
Department of Health.
In her new role she will be
responsible for delivering and
managing the transition to a new
health and care system and lead
on public health matters across
government.
Director
General quits
ABPI
The ABPI is searching for a new
Director General.
Dr Richard Barker is to stand down
at the Association’s Annual Meeting
next May to pursue new opportunities
in healthcare. Simon Jose, President of
the ABPI, said Dr Barker had been a
“champion” for the Association during
his six-year stay.
The perfect
outcome?
The days when healthcare standards were judged on meeting process targets are over.
Thoreya Swage questions whether the the new NHS Outcomes Framework is indeed the
best way forward.
Pharmaceutical Field October 2010
T
he coalition Government’s
grand scheme for the
Health Service, Equity and
excellence: Liberating the NHS, was
launched in July proposing many,
and to some, radical changes in the
way healthcare is delivered. This
was accompanied soon afterwards
by a flurry of consultation papers;
one of which is a proposed
outcomes framework, against which
performance of the NHS would be
assessed.
For a number of years, the
NHS has tried to demonstrate
its effectiveness using various
methodologies and the latest
consultation paper is no exception.
Transparency in outcomes - a
framework for the NHS is the
Government’s attempt to bring the
NHS to account for the many and
varied interventions that are carried
out on a daily basis.
Showing an improved quality
of care has always been difficult
particularly with nationally
determined process targets which
the Government claims to have
distorted clinical priorities and
restrained innovation. However, it
is a tall order to attempt to measure
the success of approximately 300
million consultations in general
practice and 1400 different types
of hospital-based treatments for 7
million routine admissions, as well
as a similar number of emergency
admissions a year.
The paper proposes that the
Secretary of State will, following
consultation, set the national
outcomes against which the newly
established NHS Commissioning
Board will be held to account.
In turn, the GP commissioning
consortia will be responsible,
through their local commissioning
of services, for improving health
outcomes by the Board. The
document is at pains to say that
the indicators for measuring the
outcomes will be based on the best
available evidence and it will not be
used as a stick to punish providers of
NHS care.
How the framework will
work
Once the indicators are set, the
Board will decide how best to
deliver the improvements. This will
be done by working with the GP
consortia and using the tools and
levers available. For example, the
Board will be able to commission
quality standards from NICE.
These will inform the development
of commissioning guidance which
will provide the details on how
the national outcome goals in the
framework could be met. The Board
will also use the quality standards
to design mechanisms for incentive
schemes, e.g. Commissioning for
Quality and Innovation (CQUIN)
and other payment frameworks.
it is a tall order to
attempt to measure
the success of
approximately 300
million consultations
in general practice
and 1400 different
types of hospitalbased treatments for
7 million routine
admissions
The principles guiding the
development of the NHS Outcomes
Framework include the long held
ideals of accountability, transparency
and balance with a focus on what
matters to healthcare professionals
and patients, plus partnership
working with other public services
as necessary. The requirement for
balance is what remains of Lord
Darzi’s review of the NHS carried
out in 2008 under the previous
administration whereby services
would be assessed in terms of
effectiveness, patient experience and
safety.
The emphasis of this framework is
on ensuring excellence and moving
away from minimum standards
which is the responsibility of the Care
Quality Commission. A new direction
has been set with the requirement to
have measures that are internationally
comparable and the data collected
to be publically available.
Furthermore, in addition to
clinical outcome measures, patient
reported outcome measures
(PROMs) will feature equally as
a means of recognising patient
experience and safety.
There will also be measures that
will only be met if the NHS works
with other public sector agencies,
such as social services and the
new public health service. Work
is afoot to construct and consult
on outcomes frameworks for these
bodies by the Department of
Health so that these integrate well
with those for the NHS.
The first outcomes framework
will be modest using current
indicators for which data can be
collected and is due in 2011/12.
The intention is to develop this
over time as the NHS landscape
changes, with annual reviews of the
indicators.
Potential measures
The potential measures, taken from
the principles identified by Darzi,
are placed under five domains.
Domain 1 – preventing premature
deaths
Domain 2 – improving the quality
of life for people with long term
conditions
Domain 3 – facilitating the
recovery of people who have had
episodes of illness or injury
Domain 4 – ensuring a positive
experience of healthcare
Domain 5 – looking after people in
a safe environment and protecting
them from avoidable harm
Domains 1-3 cover effectiveness,
whilst domain 4 covers patient
experience and domain 5, safety.
The domains themselves will
be formed of three sections: an
overarching indicator, improvement
areas and NICE quality standards.
The overarching indicator allows
the progress of the NHS to be
assessed in the broad activity areas
that are covered by the relevant
domain. Under each overarching
indicator there will be identified
areas where improvements are
expected to be made. These will be
accompanied by specific outcome
indicators against which the NHS
Quick Read
• Transparency in outcomes - a
framework for the NHS sets out
suggested standards to measure
effectiveness of the NHS
• Judging the Health Service is
difficult with the high number
of primary and secondary care
admissions
• The newly established NHS
Commissioning Board will
be held to account to national
outcomes.
• Soon to be formed GP
commissioning consortia will be
responsible for improving health
outcomes by the Board
• The first outcomes framework
will use current indicators and
are due in 2011/12; these will be
developed with annual reviews of
indicators
• Potential measures for the NHS
are placed under five domains
• Domains will be formed of:
an overarching indicator,
improvement areas and NICE
quality standards
• Government attempting to shift
the focus of the effectiveness
of healthcare from process to
outcomes
• Pharma well placed to assist
GP consortia and impose own
solutions
Commissioning Board will be held
to account for progress achieved.
Supporting all of these outcomes
will be quality standards produced
by NICE and commissioned by
the Board. The GP consortia
are expected to refer to the
commissioning guidance – based
on the quality standards – when
commissioning services locally.
NICE has already started with
the publication of three quality
standards this year covering
stroke, dementia and venous
thromboembolism (VTE)
prevention. A further ten are
in development with specialist
neonatal care, depression, chronic
obstructive pulmonary disease
(COPD) and chronic kidney disease
furthest down the line – expected
publication date June 2011, except
for neonatal care which is October
2010. The final tally is anticipated
to be around 150 quality standards
providing guidance on what high
Figure 1
Domain
Overarching indicator
Improvement areas (outcome indicators)
1. Preventing premature deaths
Mortality modified by healthcare
Heart disease – premature deaths
Cancer – 1 and 5 year survival
Stroke - premature deaths
Children - premature deaths
Older people – healthy life expectancy
2. Improving the quality of life for people with
long term conditions (LTCs)
PROMs for a number of LTCs
Children and young people – school attendance and
avoidable admissions
Adults – ability to work and avoidable admissions
Older people – independent living and avoidable
admissions
3. Facilitating the recovery of people who have had
episodes of illness or injury
Avoidable emergency admissions and
re-admissions
Planned care
Unplanned care
4. Ensuring a positive experience of healthcare
Patient experience
Patient surveys covering a range of services from primary
and secondary care to mental health and end of life care
5. Looking after people in a safe environment and
protecting them from avoidable harm
Number of incidents reported
Safe treatments, environment, discharge, safety and vulnerable groups
quality care should look like for a
specific pathway or service.
The structure of the framework
is different from what has been
developed in the past and the
illustration above (Figure 1) shows
what the five domains would look
like.
All of the above domains,
overarching indicators and
improvement areas will be
supported by quality standards.
Clearly the Government is trying
hard to shift the focus of the
effectiveness of healthcare from
process to outcomes and many
possible indicators have been
identified in the consultation
document to get the discussion
going.
Implications for pharma
The Government is keen for GP
consortia to have the flexibility to
commission services according to
local needs, which means getting
close to the emerging groups
and starting discussions around
pathways of care and service
redesign. Although the go-ahead
pioneer, GP consortia will have
their own ideas on how to change
services and there will be many
who will require more help and
support. Pharma is well placed to
formulate solutions whether it is
change management, lean design or
streamlined care pathways.
When it comes to comparing
performance of the NHS with other
the GP commissioning
consortia will
be responsible,
through their local
commissioning
of services, for
improving health
outcomes by the
Board. The document
is at pains to say
that the indicators
for measuring the
outcomes will be based
on the best available
evidence and it will
not be used as a stick
to punish providers of
NHS care
countries, the industry has a great
advantage in that it can dip into its
operations overseas and bring the
wealth of experience to bear in the
UK. The fact that the indicators
are meant to be evolving over time
provides an opportunity for pharma
to suggest new and different measures
based on the international experience
within the industry.
The second domain, improving
the quality of life for people with
long term conditions, opens up a
range of possibilities for change and
improvements in clinical practice.
For example, the consortia will be
keen to bring services ‘in-house’
within primary care rather than
secondary care for conditions such
as diabetes, COPD, chronic kidney
disease, coronary heart disease and
so on. There will probably be moves
to make more use of specialist nurses
or community pharmacists who
increasingly will be making decisions
about patient care without necessarily
referring back to the GP.
The key sets of documents which
will be produced to support the
consortia will be the commissioning
guidance and the quality standards
published by NICE. These standards
provide a description of what a high
quality service should be, but will not
go into the detail thereby allowing
innovation locally. It is here that
pharma can provide a helping hand
to the emerging GP consortia on how
to manage various conditions better,
VTE for example.
The paper has set the scene for
assessing the performance of the
NHS through outcomes rather
than process targets. Clearly further
work needs to be done, however,
preparations for the new world can be
continuing pending the outcome of
the consultation in December.
Dr Thoreya Swage has several years’
experience in the NHS, both as
a clinician (psychiatry) and as a
senior manager, including Executive
Director for a Health Authority, in
various NHS organisations covering
acute and primary care. She has
expertise in commissioning health
services, most recently working
with the independent sector as
part of the Independent Sector
Treatment Programme at the DH.
She is currently working for a
number of NHS organisations,
including DH agencies, to develop
a more commercial approach to the
commissioning of healthcare.
xx
A valuable
benchmark
Everyone is talking about account management, and every company seems to suggest that
they are doing it – but what is the reality? NHIS offers an insight into industry perception.
D
uring June 2010,
the National Health
Intelligence Survey (NHIS)
launched the Account Management
Benchmark Survey – a repeat of the
very successful survey conducted
in 2008. The aim of the survey was
to increase understanding of sales
executives’:
• skill to work across a local health
economy
• capability to influence new and
traditional customers
• propensity to work as account
managers
• confidence of working in the new
and changing NHS
The survey was posted online and
comprised of 45 questions. It remains
open and almost 200 people have
responded. The questions support
a capability model which consists
of three domains – knowledge,
influencing skills and working across
local health economy, and nine
elements, as shown in Figure 1.
Figure 1: capability mode
(NHIS 2010)
9. Team Working
and Partnership
1. Own and
Competitor
Products
8. Commercial Focus
7. Market Analysis,
Account Strategy and
Planning
2. Use of Supporting
Data
C. Working
across local
Health
economy
A. Knowledge
3. NHS Customers
B. Influencing Skills
6. Influence
and Impact
4. Customer
Focus
5. Interpersonal
Communication
Skills
Figure 2: respondent’s roles
KAM, NHS Liaison
The results – who has
responded?
The survey is anonymous to ensure
that people answer the questions
openly and truthfully. However, a
few profiling questions were asked,
for example, respondents recorded
their primary role and the results are
shown in Figure 2.
About two thirds of respondents
classed themselves as either Key
Account Managers or as having an
NHS liaison role, 16% indicated
Specialist Care
Representative
Other
they were Specialist Representatives,
whilst the remainder comprised of
a variety of diverse roles, with less
than 7% of respondents indicating
they had a role as a GP or GP and
Specialist Care Representative. You
will see in the later analysis that
results are shown separately for these
three key groups.
Almost 80% of respondents had
worked in the pharma industry for
over 10 years (as shown in Figure 3).
This figure hardly differs across the
three role types as mentioned above.
Respondents were also asked to
record how long they had worked in
their current role (shown in Figure 4).
No clear pattern emerges here with a
range of responses from 0-6 months
to +10 years for each of the role types.
However, around 50% of respondents
have been in their current role for
between 3 and 10 years, and only
about 18% have been in their current
role for less than one year. Overall
this suggests that those responding
to the survey are experienced pharma
personnel with a range of experience
in their current role which therefore
forms an appropriate group to
build an understanding of account
management experience within the
industry.
Skill level
The interim results shown in Figure
5 compare the varying levels of
performance for each of the nine
elements of the capability model
(Figure 1) for each of the three role
types.
It is interesting to note that the
mean score is higher for the KAM
and NHS liaison role across all
elements when compared to the
other two role types. Also of note
is the similarity of the elements
which were scored the highest and
lowest across the three role types.
(Figure 6 & 7)
Team working and partnership
received the highest score of all
the elements for the KAM and
NHS liaison role. It is interesting
to see the spread of scores across
the three role types, for one of the
questions supporting that element.
Figure 8 shows that 32% of
KAM and NHS liaison role
respondents scored this question
“to a full extent”. This increased to
45% of respondents for the Other
role and fell to only 10% for the
Specialist Care role showing the
value of analysing the results at
an individual question level, and
the variety of results between the
different role types. Unfortunately
the analysis of results at this level
goes beyond the scope of this
article, but it shows the in-depth
information that surveys such as
this can provide.
Figure 3: pharma industry experience
Comparison of the time in the industry by role type
100%
90%
KAM, NHS Liaison
80%
Specialist Care Representative
70%
Other
60%
50%
40%
30%
20%
10%
0%
2-4 years
<2 years
5-10 years
>10 years
Time in the Industry
Figure 4: time in current role
Comparison of time in current role by role type
40%
35%
KAM, NHS Liaison
30%
Specialist Care
Representative
25%
Other
What do the results say?
20%
It is probably worth reflecting
on the key capabilities that are
required for a successful account
manager and how they differ from
those for a successful sales person.
(Figure 9)
It is encouraging to note that
Team Working and Partnership
and Customer Focus were
amongst the top three highest
15%
10%
5%
0%
0-6 months 7-11 months
1-2 years
3-4 years
5-10 years
>10 years
Time in Current Role
Figure 5: self perceived capability scores
5.00
4.80
4.60
Mean Score
4.40
4.20
Maximum Achievable Score
Overall Total
KAM, NHS Liaison
Specialist Care
Representative
Other
4.00
3.80
3.60
3.40
3.20
3.00
Commercial Focus
Market Analysis,
Account
Strategy & Planning
NHS Customers
Impact and
Influence
Use of
Supporting Data
Customer Focus
Interpersonal
Communication Skills
Team Working &
Partnerships
Quick Read
•
•
•
•
•
•
Results from 2010 NHIS
Account Management
Benchmark Survey
Almost 80% of
respondents worked in
pharma for over 10 years
KAMs and NHS
liaison believe they are
performing better than
other roles
Team Working &
Partnerships highest
perceived element
Knowledge of Own &
Competitor Products
surprisingly lowest
element
Distinct capabilities
between sales manager
and account manager
scores for the account manager role
and fit well with the description given
above. However, those elements were
also amongst the top three for the
Specialist Representative and Other
roles, which may not be what would
have been expected. When looking
at the lowest scoring elements for
the KAM and NHS liaison role it
is surprising to see Market Analysis,
Account Strategy and Planning, and
Commercial Focus in that list. This
becomes even more surprising when
looking back to the 2008 survey
which also listed these amongst
the lowest scoring elements –
additionally the score for both these
elements has fallen slightly.
Another surprise is that Own and
Competitor Product Knowledge is
the lowest scoring element for the
KAM and NHS liaison role. Surely
this element is a fundamental skill for
any customer facing role? As should
be knowledge of the customer –
NHS customer knowledge – which
is also in the three lowest scoring
elements for two of the three roles,
and it is ranked fourth lowest for the
KAM and NHS liaison role.
Taking an overall view of the
results for the KAM and NHS
liaison role it suggests a description
of a person who believes that most
of the time they work effectively in
a team or partnership role by using
their interpersonal communication
skills, by keeping up to date with
local and national guidance,
and using such supporting data
in their interactions. But such
interactions may not be informed
through knowledge of their own
and competitor products, and
commercial focus may be hampered
through a lower level of market
analysis, account strategy and
planning. Such a description may be
the cause of some concern amongst
managers within the industry since
it is a similar description to that
resulting from the 2008 survey,
suggesting that capabilities have
not advanced since then. But the
major cause of concern should be
the low scores which suggest a lack
of analysis, strategy formation and
planning leading to a low level of
commercial focus.
The next step
Although this is only an interim
analysis and the number of
respondents is growing on a
daily basis – as are the number
of companies participating in
the survey – it is hoped this has
provided an interesting overview
of account manager capability, and
that it has made apparent how this
type of survey can support normal
performance measures used within
a company to provide a valuable
insight into your strengths and
weaknesses. Plus the areas where you
may have a competitive advantage.
This type of survey is also a valuable
way to identify future training
interventions, and whether any
training intervention is providing
the outcome you expected.
It should be remembered that
this survey is a measurement of
self perception against a capability
model; the real value of this
insight being delivered through
the comparison to an industry
benchmark. The next step would
be to perform a similar survey
with customers in a manner that
would allow a comparison of
the self perception score and the
customer perception at an individual
account manager level. It should
also be noted that a small number
of companies are interested and
have started to perform this type of
analysis.
If you wish to know more about
the survey, the interim results,
or how you can benchmark your
whole team, please contact Neil.
[email protected].
Figure 6: lowest elements by role type
Lowest three scores
KAM, NHS Liaison
Own & Competitor Products
Commercial Focus
Market Analysis, Account
Strategy and Planning
Own & Competitor
Products
Market Analysis, Account
Strategy & Planning
NHS Customers
NHS Customers
Use of Supporting Data
Impact and Influence
Other
Specialist Care
Representative
Figure 7: highest elements by role type
Highest three scores
KAM, NHS Liaison
Other
Specialist Care
Representative
Team Working &
Partnerships
Interpersonal
Use of Supporting Data
Interpersonal
Team Working &
Partnerships
Customer Focus
Team Working &
Partnerships
Interpersonal
Customer Focus
Figure 8: building long term relationships score by role type
I am more concerned with building long term, open and honest business relationships, in preference to taking a
quick win now which may not help the long term relationship
Specialist Care
Representative
Other
KAM,NHS
Liaison
0%
Not at all
20%
To a small extent
40%
60%
To some extent
80%
To a large extent
100%
To a full extent
Figure 9
Sales Person
Account Manager
Usually works alone
Works as part of a team
Employed to “get the sale”
Works to achieve a long term relationship, leading to greater
customer retention, and improved profitability
Manages a large number of customers
Manages a smaller number of customers
Customer relationships are simply to achieve the sale
Tasked to understand customer’s need and develop their
potential over time by meeting that need and through long
term customer relationships
Employs a common message to “push the product”
Marshalls and deploys resources from across their
organisation as appropriate to meet customer need
NOVEMBER 2010
Market to define value
NICE is to be stripped
of its power to decide
which treatments are
available on the NHS, the
Department of Health
has confirmed.
From 2014, the
medicines watchdog’s
health technology
appraisal role will be
downgraded to make way
for value-based pricing.
November 2010
You are
not alone
New
rewards
(I can’t get no)
satisfaction
p20
p18
p26
Market to define value as
NICE role ‘downgraded’
NICE is to be stripped of its power to
decide which treatments are available on
the NHS, the Department of Health has
confirmed.
From 2014, the medicines watchdog’s
health technology appraisal role will be
downgraded to make way for valuebased pricing.
But the DH said that comments from
Health Minister Lord Howe which
described NICE’s role in making costeffectiveness decisions as ‘redundant’ had
been taken out of context, and that the
work of the Institute would remain vital
in the future.
Speaking at the ABPI’s half-day
conference earlier this month, Lord
Howe said: “The role of NICE in
appraising new drugs is likely to evolve
as we develop and implement our plans
for value-based pricing, but we are clear
that NICE will continue to have an
The DH says Lord Earl Howe’s comments that
NICE’s HTA role would become ‘somewhat
redundant’ have been taken out of context
PF-NOV-NEWS - EDIT IB.indd 1
essential advisory role, whatever that
shape of value-based pricing will be.”
Value-based pricing is expected to be
introduced by the end of 2013, when
the current PPRS expires. Lord Howe
confirmed the Government would
commit to the existing PPRS agreement
“in full” but said it did not do enough
to promote innovation or access. “We
need a much closer link between the
price the NHS pays and the value that a
new medicine delivers. But coming up
with a system defining what represents
value is not a straightforward matter.
Over the next four years or so, we will
work with patients and clinicians, with
the NHS and of course with industry to
define how best to reform the pricing of
medicines.”
Lord Howe’s remarks echoed the
words of Health Secretary Andrew
Lansley, who told a UK Prix Galien
audience that more needed to be done to
promote innovation and to ensure that
NHS patients get access to the medicines
they need. “In July, Mike Richards, the
National Cancer Director, published
his report on the international variance
in drug use and set out very clearly the
deficiencies we have in terms of access
to cancer drugs in this country,” he
said. “We are addressing that directly,
but in an interim fashion. Beyond that,
we will shortly be publishing the initial
consultation looking at a longer term
structure beyond the current PPRS, to a
NICE decisions have
regularly caused
controversy, particularly
in the emotive area of
cancer. The Government’s
introduction of a Cancer
Drug Fund is designed
to improve access to
cancer therapies – but is
only an interim measure.
The refocusing of NICE,
which unions now claim
will make the NHS and
patients the ultimate losers,
will have wider long-term
implications.
system that is focused on the successful
delivery of medicines in this country,
based on the value they contribute. And
by value, I mean not only the therapeutic
benefits to patients, but also the benefit
to society. But if we don’t recognise the
value associated with innovation, we will
not get the new medicines we need and
will not get the growth in our economy
that we need to sustain our preeminent
position in pharmaceutical research.”
Last month, the ABPI called for a
change in NICE’s remit to equip it for
the value-based era. “As debate begins
on the design of a future value-based
approached to how the NHS pays for
its medicines, it’s vital we have a parallel
debate on the role and focus of NICE,”
said Richard Barker, Director General
of the ABPI. “If we want the NHS and
the UK to benefit from a vigorous life
sciences sector, the reshaping of NICE’s
remit is an urgent priority. A focus on
the future value of innovation, rather
than decisions made on narrow costeffectiveness criteria, would mean NICE
could play an important pivotal role in
an outcomes-driven NHS.”
Dr Barker said that the issue of how
drugs are reimbursed will be just one
factor in how patient access to medicines
can be improved. “How they are built
into NICE’s view of clinical best practice
and quality standards, and then brought
into wide use in the NHS, will clearly be
of equal importance,” he said.
IMS predicts
growth
GSK sales have fallen in the thirdquarter following the suspension
of Avandia and decreasing use of
Relenza as the flu pandemic peters
out.
The company posted a total sales
decline by 2%, but saw figures
increase by the same amount when
Avandia and the H1N1 product were
removed.
The global pharmaceutical market
is expected to recover in 2011, with
predicted growth of 5-7%, according
to IMS Market Prognosis.
IMS Health has estimated a
market value of $880 billion for
2011 and accelerated growth
compared to the 2010 rate of 4-5%.
ABPI Code
changes
The ABPI has voted in favour of
amendments to the ABPI Code
of Practice which aim to increase
transparency and help break down
barriers to trust.
The amendments include stricter
regulations on the promotional
items industry representatives can
provide to healthcare professionals
(HCPs).
Teva buys
Théramex
Merck Serono is to sell Théramex,
its Monaco-based women’s health
business, to Teva for 265 million
euros.
Teva will acquire 100% of the
shares of Théramex S.A.M. of
Monaco and Théramex S.p.A. of
Italy, as well as the distribution
rights of Théramex products in
certain countries, including Spain
and Brazil.
The Government will increase NHS
funding by the minimum needed to
meet its “real terms increase” pledge as
part of the comprehensive spending
review.
Funding will rise by just 0.1% above
inflation from next year onwards from
£104bn to £114bn in 2014-15.
The DH has decided not to introduce
generic substitution as proposed by
the 2009 PPRS, following public
consultation.
The Government said that it intends
to stand by the 2009 PPRS agreement,
but would explore other ways of
supporting the use of generics.
Pfizer to buy
King
10/11/2010 12:00
GSK posts
losses
Andrew Witty
Funding to rise DH rejects
after CSR
substitution
George Osborne
Cancer fund
confirmed
A £600 million Cancer Drugs Fund
has been confirmed by Health Secretary
Andrew Lansley.
From April 2011 until the end of
2013, cancer patients will get greater
access to drugs recommended by their
doctor through £200m of funding each
year.
Pfizer is to acquire King Pharmaceuticals,
a diversified specialty pharmaceutical
discovery and clinical development
company, for $3.6 billion.
The merger will create one of
the leading broad portfolios for
pain relief and management in the
biopharmaceutical industry. King’s
products in this area include Avinza,
the Flector Patch and Embeda, the first
approved opioid pain product with
design features intended to discourage
misuse, as well as other compounds in
development.
To read the full
story, click on
the headline
CHMP sees Lucentis future
Follow
PharmaField
on Twitter
Novartis’ Lucentis (ranibizumab)
has been given a positive opinion
for the treatment of visual
impairment due to diabetic
macular edema (DME) by the
CHMP.
Data from the RESTORE
and RESOLVE studies showed
the treatment was superior in
providing rapid and sustained
visual acuity gain when compared
to current care types.
NOVEMBER 2010
New drugs
expected to
earn £5bn
Management
commission
launched
The combined sales of seven emerging
breast cancer drugs are expected to
reach nearly $5bn in seven major
markets by 2019, says a new report.
The Pharmacor 2010 findings from
the Breast Cancer study predicted
sanofi-aventis’s Iniparib as a potential
blockbuster in the US, France,
Germany, Italy, Spain, UK and Japan
with sales in excess of $1bn predicted.
A new commission has been
launched by The King’s Fund
to assess the leadership and
management needs of the NHS.
It will evaluate national and
international evidence about the
current state of leadership and
management and outline the
capabilities needed to meet future
challenges.
RA treatment
given OK
AstraZeneca and Pozen’s combination
RA treatment Vimovo has received a
positive agreement for approval in 23
EU countries under a Decentralised
Procedure.
The treatment, indicated for the
symptomatic treatment of osteoarthritis
(OA), rheumatoid arthritis (RA),
and ankylosing spondylitis (AS), was
approved following a positive conclusion
from the Netherlands Health Authority
acting as the Reference Member State.
Trusts’ finances
in good shape
Union issues
warning
The majority of NHS trusts and
Primary Care Trusts are managing their
budgets well, a report by the Audit
Commission says.
The Auditors’ Local Evaluation and
Use of Resources 2009/10 showed a
sustained improvement nationally
over five years and found that the
NHS returned a surplus of £1.5
billion during an audit of the 2009/10
accounts.
The NHS and patients will pay a high
price for drugs if NICE is stripped of
its safeguarding powers, UNISON
says.
The union, who recently failed in
legal action against Andrew Lansley as
part of a campaign to save the NHS,
warns the NHS and patients will be the
“ultimate losers” under new proposals
to introduce value-based pricing
(VBP).
Professor Chris Ham
Blockbusters
expected
A new report into the future of
fixed dosing combination product
development has predicted a number
of potential blockbusters.
Exforge, Janument, Certria,
Vimovo, Dudoart and Duoplavin
were all highlighted as having huge
sales potential in The future for fixed
combination product development.
David Stout
EU
Survey reveals MabThera
approved
scepticism
Less than a quarter of doctors believe
the Government’s proposed reforms
will improve patient care, a new survey
commissioned by The King’s Fund and
Doctors.net.uk has revealed.
More positively, however, over 60%
of GPs believe there are GPs in their
area with the capacity to lead new GP
consortia.
Roche’s MabThera has been approved
by the European Commission as a
maintenance treatment for follicular
lymphoma.
The approval is based on results
from the PRIMA study which
demonstrated the use of MabThera
for two years doubled the likelihood of
patients living without their condition
deteriorating.
Mixed
outcomes for
Victoza
NICE has recommended a 1.2mg dose
of Victoza (liraglutide) for the treatment
of type 2 diabetes mellitus.
But it has failed to recommend a
daily 1.8mg dose saying the increase
did not show any “significant additional
benefit”.
NICE backs
Tyverb
decision
NICE has backed its advisory
committee’s decision on breast
cancer drug Tyverb (lapatinib)
following an appeal by GSK.
A review found the committee
followed the “correct procedures”
and did not “exceed its powers”
when it failed to recommended the
drug’s use – except in clinical trials –
in draft guidance back in June.
Vidaza appeal
fails
NICE has again decided against
recommending Celgene’s
myelodysplastic syndromes (MDS)
treatment Vidaza (azacitidine) in
preliminary draft guidance.
The Appraisal Committee decided
that its benefits did not justify the high
cost of the drug – even with a proposed
Patient Access Scheme (PAS).
Trio fail
appraisals
NICE has failed to recommend a trio
of cancer drugs in three separate pieces
of guidance.
GSK’s Arzerra (ofatumumab)
does not justify its cost, says the
appraisal committee, with NICE
unable to complete appraisals on
Pfizer’s Torisel (temsirolimus) and
Napp Pharmaceuticals’ Treanda
(bendamustine) due to a lack of
evidence.
You are
not alone
The pharmaceutical sales force is not the
industry’s sole ambassador in the field.
With companies seeking to improve
operational efficiencies and capitalise on
available resources, marketers and medics
are increasingly being deployed in more
customer-facing positions. But how much
do you understand the benefits of a crossfunctional approach? Karen Westaway puts
the developing role of the field-based medic
under the spotlight.
Pharmaceutical Field November 2010
T
he battle to become
customer-centric continues
to drive global business
strategy in the modern marketplace.
As the saying goes, if you’re not
thinking about the customer, you’re
not thinking. For the pharmaceutical
sector, the pursuit of customercentricity remains a complex and
unusual challenge; while the majority
of sectors continue to find customers
in short supply, the drug industry
faces a problem of a different kind: it
has too many. The rapid proliferation
of healthcare stakeholders and
influencers in recent years has
given pharmaceutical companies
a split customer-base – loosely
defined as clinicians and payers. As
a consequence, the challenge to be
customer-centric is a difficult one.
A key component of a truly
customer-focused organisation
is the culture of collaboration.
Customer-centricity and crossfunctional working go hand in
hand. The product-oriented sales
culture that characterised too many
historic business strategies and
led to a territorial approach where
information was rarely shared across
organisational silos is dying. Today
the silos are being broken down and
the smartest companies are tailoring
solutions to suit customer needs,
built upon linkage and cooperation
across all internal business functions.
The glue for cross-functional
working in a customer-centric
culture is marketing. But, for
pharma, without the collective
intelligence of the sales and medical
teams, the glue just won’t stick.
Marketing guru Philip Kotler
describes marketing as “the
homework your company does to
figure out what people need and
what your company should offer”.
Moreover, he says that marketing
hopes to understand the target
customer so well that selling isn’t
necessary. Clearly then, strong
marketing should not only be the
lifeblood of any customer-centric
organisation, but the vein must
run ceaselessly across all business
functions. Marketing does not begin
with the product, it begins with the
customer.
A bigger playing field
So what does all this mean for
medical sales professionals?
Traditionally, the field-force has been
considered pharma’s most valuable
customer-facing asset. Arguably, this
may still be true. But it is not the
only one. Nowadays, the industry
deploys a wide range of field-based
personnel. There has been significant
growth in the number of field-based
medical and marketing professionals,
with the wider aim of developing
a more comprehensive and holistic
understanding of individual
customer groups and their needs.
These insights are fed back through
the cross-functional brand team and
used to develop products and services
that can help customers meet their
objectives. This proactive approach
is a far cry from the traditional
methodology whereby R&D would
develop a product then pass it across
to marketing who would, in turn,
conjure up a few messages and throw
them over the fence to the field
force and hope for the best. Crossfunctional working within customercentric organisations is based on an
integrated, collaborative approach
across medical, marketing and
sales. It begins with the customer,
rather than the product, and it lasts
throughout the customer life-cycle.
Well, that’s the theory. The
question is, just how cross-functional
are you? How much insight do you
have into the roles your colleagues
from other business functions
play – and, indeed, how what they
do can impact on your customer
interactions? In this short series of
articles looking at cross-functional
working, we explore the three
distinct business disciplines that
must successfully integrate if the
goal of customer-centricity, and
subsequent commercial gain, is to be
achieved; medical, marketing and,
of course, sales. We begin with the
medical team.
Developing the medics
The idea that the medical
department is a critical component
in the commercial operation of
every pharmaceutical organisation
is no doubt an anathema to the
vast majority of those who work
within it. Historically, medics have
played a discrete supporting role in
the commercialisation of products,
allowing sales and marketing
professionals to focus on selling
drugs. But in an era driven by health
economic imperatives and HTAs,
medical departments are increasingly
being called upon to take more
responsibility for the commercial
performance and market access
of pharmaceuticals. Marketers are
urging medical teams to maximise
the interactions they have with their
customer-base – engagement that
cannot be promotional, but can have
an undoubted impact on the success
of a product.
Despite the widespread need for
companies to generate and present
cost-effectiveness data to payer
customer-groups, the value of strong
The sales force may be the industry’s biggest
collective customer facing body, but the vital
commercial interactions it has at the sharp
end are greatly enhanced by the field-based
work that takes place elsewhere within each
organisation. Employees at every level and
in every division need to nurture a deep
understanding, not only of customer needs, but
also of the important role others around them
play within an organisation – in particular those
who have key touch-points with customers.
Quick Read
• Cross-functional
working is a key
component of building
a customer-centric
organisation
• Sales professionals are
not the only field-based
professionals within
pharma companies
• Medical and marketing
personnel are being
deployed in more
customer-facing roles
• Medics can help accelerate
trial recruitment, time
to market and product
uptake through improved
early interactions with
customers
• Medics interaction with
customers is governed by
strict regulation by the
ABPI Code
• Dialogue cannot be
solicited or promotional
• Sales professionals need
to develop a detailed
understanding of how
other internal roles
support/impact their
customer interaction
clinical data has never diminished.
The effective communication of such
data can deliver significant longterm benefits for a product, but this
process is not the sole responsibility
of the sales force. It begins, long
before sales teams start taking
commercial messages to market, with
those important early interactions
between medics and customers.
How? Well, medical teams
can influence the speed at which
a clinical trial recruits patients
through effective engagement with
key investigators. Medics have been
performing this valuable role for
years, but many are unaware of the
commercial gains that can be made if
a trial completes recruitment ahead
of schedule. Equally, medics also
perform a vital role in talking to
potential customers in the months
between the completion of clinical
trials and regulatory approval.
These interactions can neither be
promotional or solicited, but the
quality of these dialogues can be
critical to the eventual success of a
product.
The interim period between
the presentation of trial data and
securing a license can often equate
to a considerable amount of time
– dead time if companies are not
making the most of available data.
For example, in cases where drugs
are likely to achieve fast-track
licensing, there can be a gap as long
as a year between the original data
presentation and the award of a
license. During this time, companies
can be leveraging the data and
preparing potential customers to
use the product once it becomes
commercially available.
To capitalise on the opportunity,
medical and scientific staff are being
encouraged to evolve beyond their
traditional mindset. In the spirit of
customer-centric, cross-functional
work, marketers are urging medics
to develop commercial competencies
and become agile thinkers. Fieldbased medics must develop a greater
understanding of the impact their
dialogues with customers can have
on the uptake of a product. Further
down the line, the benefits to sales
professionals are obvious.
Ensuring compliance
The process does not, of course,
come without risk and regulation.
The ABPI Code of Practice provides
strict governance around this
sensitive area.
STAYING WITHIN
THE CODE
•
•
•
•
Medics visits cannot be
solicited – they must be
requested
Medics must present a drug as
a generic rather than a brand
Branded materials must not
be used
Medics must use clinical
papers and clinical data
Pre-license, companies cannot
proactively seek customer
engagement about their products
– they can only engage reactively
following a customer request. What’s
more, once in situ medics must talk
about a drug in a generic sense and
present information based only on
clinical papers and clinical data.
Glossy branded materials and leavepieces are strictly prohibited by the
Code.
Despite these strict guidelines,
opportunities to raise awareness
do exist – so long as the fine line
between education and promotion
is understood and respected.
For example, if a medic is with a
customer discussing a clinical trial,
providing they stay within the rules
of the Code, there is nothing to
prevent them delivering information
about other ongoing clinical trials,
or having a broader discussion about
their company’s pipeline. This may
help drive faster patient recruitment
to a trial or compassionate use
programmes. Moreover, dialogue
between medics and customers
provides a powerful opportunity
to build advocacy in the lead up to
launch.
In an environment where
healthcare budgets are reducing and
businesses are seeking operational
efficiencies, pharma companies
are now looking to make the
most of available resource to
drive commercial advantage. As a
consequence, the evolution of more
commercially aware medical teams
is gathering pace. Marketers are
working more closely with medics to
help improve competencies such as
communication skills and objection
handling. Proactive brand teams are
developing ‘Engagement Guides’ to
provide medics with a framework
for how to communicate during
calls. There is an increased emphasis
on driving a greater understanding
of how specific aspects of a clinical
paper can be presented in ways that
have the most positive impact on the
commercial uptake of a product in
the future.
On the broader stage there are
increasing examples of companies
convening pan-European medical
team meetings where medics discuss
pipeline products and their projected
market size if licenses are successfully
achieved. Presentations are focusing
on the importance of medics
achieving outcomes and actions from
every customer interaction. Their
over-riding rationale is to drive trial
recruitment, accelerate time to market
and facilitate quicker approval and
faster uptake. Their collective purpose
is not promotional – it never can be
– but is about improving efficiencies,
capitalising on early interaction
with key customers and, ultimately,
helping ensure patients gain quicker
access to beneficial drugs.
The role of the field-based medic is,
therefore, taking on broader horizons.
There is now a steady emergence
of Clinical Engagement Managers
being deployed by pharmaceutical
companies to talk about clinical data
in an engaging and communicative
fashion. In the process, these medical
teams are now playing an incredibly
powerful role in preparing customers
for their products once they have
been licensed.
Benefits to sales
The long-term efficiencies that
can be gained from more effective
medical engagement are significant.
And nowhere will these benefits be
felt greater than in the sales force.
The key to success, of course, is in
sharing information, understanding
customer insights and using it to
develop messages that align the
individual needs of all the key
stakeholders and influencers in your
marketplace. These can be crafted
as part of a collaborative effort by
the brand team, and will ultimately
lead to sales teams being equipped
with the most effective and resonant
product messages to present to
customers.
The sales force may be the
industry’s biggest collective customerfacing body, but the vital commercial
interactions it has at the sharp
end are greatly enhanced by the
field-based work that takes place
elsewhere within each organisation.
Employees at every level and in every
division need to nurture a deep
understanding, not only of customer
needs, but also of the important role
others around them play within an
organisation – in particular those
who have key touch-points with
customers.
For the sales professional, it is
important to understand that, despite
the apparent solitude of your fieldbased role, you are not alone. The
commercial imperatives of marketing
pharmaceuticals are a collective
responsibility that began long before
your brand won its license.
Delivering a cross-functional
approach that ultimately generates
a truly customer-centric culture
requires the right attitude and a
commitment to pool expertise,
share information and collaborate
effectively. Communication, a
core competency of every sales
professional, lies at the heart of
a cross-functional approach. The
interactions you have with peers
and colleagues from across your
organisation will have a major
impact on the dialogues that
take place between you and your
customer. Being customer-centric
means aligning the resources of
your company to the ever-changing
needs of customers and, in the
process, building mutually profitable
relationships. It is a mindset, and
it encompasses every aspect of an
organisation.
Next month, we will look at the
role marketing plays in a crossfunctional brand team.
Karen Westaway is Joint Chief
Executive of WG Group. WG
provides a range of bespoke
services to improve market
access opportunities for
pharmaceutical companies
in the UK.
For further details, please visit
www.wg-group.co.uk
(I can’t get no)
satisfaction
The age-old question of whether we work to live, or live to work, still rumbles on today.
But with companies doing more than ever to improve working practices, why is it that
work-life balance is still a major concern? Pf’s Iain Bate reports.
I
t would seem there’s never been
a better time to be an employee.
Of course there’s the worry
of job security and the complaint
about being underpaid, which, let’s
face it, will always be a contentious
issue, but companies are now doing
more than ever to please their
workforce and bring an equilibrium
of work-life balance. Pf ’s annual
Company Perception, Motivation and
Satisfaction Survey, which provides
an accurate insight into the attitudes
of sales personnel in the industry,
showed that work-life balance was
the third main motivational factor
whilst at work. However, despite it
being one of the main drivers, it was
surprisingly voted one of the least
satisfying aspects for respondents.
Clearly employers still need to do
more.
The survey says
More than a third of people in the
survey said they were still unhappy
at their level of work-life balance;
despite advances in maternity and
paternity leave, and the right to
request flexible working hours
for those with children under six,
aimed at increasing morale and
happiness within the workforce.
Women were the least satisfied when
juggling life at home and at work
with 44% admitting their level of
unhappiness. Unsurprisingly parttime staff said they were the most
satisfied when questioned on their
level of satisfaction with 60% saying
they had no complaints between
working only a few hours a day
then enjoying favourite pastimes
or family time. The younger
generation – 25 years old to 34 years
old – enjoyed the balance between
work, rest and play the most with
those aged between 45 and 54
complaining of an in-balance.
Professor Suzan Lewis, research
leader of the Human Resource
Management department at
Middlesex University, says it’s not
uncommon for the there to be a
distinct difference between the levels
of motivational and satisfaction
where work-life balance is concerned.
“It is often due to a gap between
policy and practice,” she explains.
“There is evidence that polices can
be undermined even in supportive
companies by non supportive
managers or a culture in which it
is not acceptable to ask for flexible
working hours, especially for men.
“However, another factor is
workload. As people have more
and more intense workloads,
policies such as flexible working
arrangements are often used as tools
to work harder, for example, taking
work home or working at weekends.
Or, if people who work reduced
hours find there is no replacement
for the work that they are no longer
doing – as is often the case, either
their colleagues have to pick up some
of their work, causing relational
problems, or they have to work
harder to fit in a full workload in
reduced time. I have seen plenty of
evidence of all these things.”
Within the industry, (see Figure 1)
NHS Liaison officers were the most
satisfied with more than half giving
the thumbs up to the balance in their
‘downtime’ and work life. However,
only a few doors away, hospital
specialists were the least satisfied
with 41% hoping for some sort of
change. Despite having the benefits
of holiday or sick pay, full time staff
employed in the industry (45%)
were only slightly more satisfied than
counterparts working for an agency
(44%).
The working week
Alongside the ‘perks’ of a job, it’s
the amount of time whilst at work
which seems to be the main bugbear
for employees. According to the
Office of National Statistics, full-time
workers in the UK average 37 hours
per week, part-timers do on average
15.5 hours and just over a fifth of
people in employment work more
than 45 hours a week. While this may
be more compared to EU standards,
other developed countries such as
Australia, Japan and the US have
a higher proportion of ‘long hour
workers’ than the UK.
The main regulations governing
working time are the Working Time
Regulations 1998 (WTR). The
WTR implement the previsions of
the original directive and include
conditionals relating to weekly
working time, rest entitlement and
annual leave, plus special provisions
for those working through the night.
The basic WTR rights and
protections include:
Figure 1
•
•
•
•
•
•
Job title
Satisfied
Dissatisfied
No opinion
1st line manager
33%
35%
32%
NHS liaison
52%
12%
36%
Sales representative
47%
26%
27%
Key account managers
47%
30%
23%
Hospital specialists
38%
41%
23%
A limit of an average of 48 hours
a week over a 17 week period
A limit of an average of 8 hours
work in a day which night
workers can work
A right to 11 hours rest a day
A right to a day off each week
A right to an in-work break if
the working day is longer than
six hours
28 days paid leave for full-time
workers per year.
Under the WTR, employers are also
legally obliged to provide special leave in
certain circumstances, for example, court
service or military training and service.
A review of the literature between
long days at work and health for the
Health and Safety Executive in 2003,
said that “there is some evidence that
working long hours can lead to stress
or mental ill-health”. Stress-related
absence levels have increased in the
past year and are now the main cause
of long-term absenteeism in the public
sector. According to the Chartered
Institute of Personnel Development
(CIPD), workers in the public sector
took an average of 9.6 days off sick
last year, three more than the private
sector, as a result of stress.
Although stress is considered a
personal problem, Professor Lewis
believes companies can still do more
to reduce the pressure placed on staff
in the office. “Through management
support and line manager training –
to value people who want work-life
balance – employees are less likely to
get burnt out than those who work
all the time,” she continued. “Also,
companies can help by questioning
deeply embedded assumptions that
ideal workers should be available and
visible all the time. Good employers
value workers’ outputs, rather than the
amount of time they spend at work.”
Pharma fights back
More and more companies now
realise the importance of providing
the right blend between time spent
at work and at home. Pharma is no
different and recently had several high
profile companies included in the US
Working Mother magazine’s 100 Best
Companies 2010. Abbott, AstraZeneca
(AZ), Boehringer Ingelheim,
Bristol-Myers Squibb, Eli Lilly,
Genentech, Merck (MSD in the
UK), Novo Nordisk, Pfizer and
sanofi-aventis were all included in
the list for their various work-life
balance friendly policies.
Quick Read
• Third of respondents
in Pf survey unhappy
with work-life balance
• Men more satisfied
than women
• 60% of part-time staff
satisfied with work-life
balance
• Younger workers more
satisfied than elder
colleagues
• UK full-time workers
average 37 hours per
week; part-time 15.5
hours; and a fifth work
more than 48 hours per
week.
• Long hours and high
workloads result in
high levels of absence
through stress
Nearly 90% of employees at
Abbott enjoy flexible working
schedules where an on-site
childcare centre at its headquarters
in north Chicago, Illinois, looks
after children full-time and
also offers therapy for disabled
children. AstraZenca provides
childcare programs and peer
mentoring schemes. It also hosts
the Working Parents Network
which offers advice on familyfriendly topics such as meal
planning and managing home
finances.
Boehringer Ingelheim entered
the top 100 for the first time after
providing an impressive range
of benefits for both mothers and
fathers. Bristol-Myers Squibb
now allows expectant mothers 24
job-guaranteed weeks off after the
birth of a baby and has recently
opened its fifth childcare centre,
with full-time, part-time and
back-up care for over a hundred
children. BMS also stages summer
camps and free classes on healthybaby care.
Eli Lilly’s provides access to the
company’s 267-acre park near
their headquarters in Indianapolis,
Indiana, and free memberships
to local gyms. It was also noted
that in 2009, 90% of employees
adjusted their working hours in
their favour. The latest “coolest
addition” for employees at
Genentech is CareerLab, a facility
at HQ in south San Francisco,
which offers career counseling,
skills workshops, mentoring
sessions and networking events.
Companies can help by questioning deeply
embedded assumptions that ideal workers
should be available and visible all the time.
Good employers value workers’ outputs, rather
than the amount of time they spend at work.
Merck continued the trend of
trying to adjust work-life balance
and morale when it launched its
Exceptional Caregiving website in
2009. The site provides a variety
of resources for those raising
kids, teens and young adults with
special needs. The company also
doubled its adoption aid benefit
to $10,000 and gave parents who
adopt one fully paid week of
leave. Novo Nordisk was one of
the highest companies on the list.
It launched the popular ‘Saving
and Paying for College’ seminar
for employees with children of
all ages. Parents can also enjoy 80
hours of cheap in-home or centrebased back up care annually for
use with dependents and ill family
members.
Female Pfizer employees
have the opportunity to use the
company’s Reproductive and
Neonatal Resource Service, which
provides a personal nurse and
helps them locate top infertility
centres across the US. New mums
are also allowed to spend the last
three weeks of their pregnancy
at home and are granted 32
weeks off after the birth. Sanofiaventis was particularly noted
for offering online tutoring
and SAT test prep for kids ages
four to 18 and financial, as well
as medical aid, for children in
need of developmental therapy,
special types of dependent care
or upgrades to make their homes
more accessible.
The right mix
Despite pharma companies
introducing more working
practices in an attempt to keep
employers in work, and happy
while they’re there, the CIPD still
believes that even in these difficult
economic times, employers should
protect their workforce from being
overworked. Where employees are
working consistently long hours,
this has a negative impact on
their employment performance or
wellbeing.
“I do think it’s a company
responsibility (to improve
satisfaction levels of work-life
balance),” added Professor
Lewis, “not just ethically but also
because there is lots of evidence
that workers with good work-life
balance are more effective. It’s
also a governmental responsibly
to ensure the wellbeing of
individuals, families and
companies. Anything companies
can do to challenge assumptions
that ideal workers do not need
work-life balance is helpful – but
it’s not easy as these assumptions
are rarely challenged.”
It would seem the message is
simple – although not always
practical for employers: promote
a restructuring of working time
and the methods in which people
work to correct the balance between
work life and time spent at home; and
finally get the best out of people whilst
at work. After all, a happy worker is a
productive one.
• Are you being paid enough?
• Do you feel secure in your job?
• Is your work-life balance leaning the right way?
Have your say on these issues and many more.
The Pf Company
Perception, Motivation
and Satisfaction Survey.
online at www.pharmafield.co.uk
DECEMBER 2010
Pharma not providing value
for money, say MPs
The majority of UK
MPs do not believe the
pharmaceutical industry
provides value for money for
the NHS, new research has
shown.
The study, conducted
jointly by ComRes and
Westminster Advisers, says
the sector must do more to
demonstrate its value to the
nation’s health.
December 2010
Choppy
waters
Chorus of
approval
Transparency
and disclosure
p12
p18
p22
Pharma not providing
value for money, say MPs
The majority of UK MPs do not believe
the pharmaceutical industry provides
value for money for the NHS, new
research has shown.
The study, conducted jointly by
ComRes and Westminster Advisers, says
the sector must do more to demonstrate
its value to the nation’s health.
It also suggests that a high number of
MPs do not trust the communications
they receive from the industry.
The Pharmaceutical Industry
and Parliament: a joint report on
parliamentary opinion towards the
pharmaceutical industry reveals that
while MPs from all three main parties
have a high regard for the economic
importance of the pharmaceutical
sector, a worrying 62% believe that the
prices the industry charges the NHS
for medicines do not deliver value for
money. Almost two thirds of MPs (64%)
NICE says no to Avastin again
NICE has again failed to
recommend the use of cancer drug
Avastin for use on the NHS – this
time in breast cancer.
The Institute decided against
recommending the drug when used
in combination with chemotherapy
for people whose breast cancer has
spread in final draft guidance.
It is the second time inside a
month that NICE has failed to
recommend Avastin following its
recent appraisal for the treatment
of metastatic colorectal cancer (p9).
support the introduction of a valuebased pricing system.
The research highlights that only
40% of MPs trust the communications
they receive from the industry. The
highest levels of scepticism appear to be
among Labour MPs, with 74% of those
surveyed believing the industry does not
provide value for money and only 23%
trusting industry communications. More
than half (53%) of Conservative MPs
trust the communications they receive.
Tony Black, Head of Healthcare
Research at ComRes, said: “Value for
money is the be all and end all for all
public policy debates at the present
time. Improving levels of trust among
MPs towards the communications they
receive from the pharmaceutical industry
is crucial if pharma is to put itself on the
right side of the value debate.”
Proposals to introduce value-based
pricing were unveiled last month,
with the new pricing method set to be
introduced towards the end of 2013
when the current Pharmaceutical Price
Regulation Scheme (PPRS) expires.
The present PPRS caps the profit
pharma companies can make from
NHS sales at 29.4%. However, under
the Government’s proposed model,
companies can set initial prices which
are then reviewed to establish cost
effectiveness – with either the NHS or
pharma reimbursed against the original
cost, dependent upon the outcome of
the review.
However, the ABPI has warned that
the new model may not deliver the NHS
savings the Government anticipates.
Its Director General, Richard Barker,
recently told a conference audience:
“There is an unrealistic belief in the
Government’s mind that the result is
that prices will fall. But I don’t think we
know. Value-based pricing is thoroughly
logical, but not a magic bullet.”
The ComRes/Westminster Advisers
survey showed that only 34% of MPs
agreed Britian has poor uptake for new,
innovative medicines relative to other
European countries, and that 41% ‘don’t
know’. The report indicates that there is
scope for the industry to take a greater
initiative in educating parliamentarians
about this critical issue.
THIS IS EXCITING/CHALLENGING/VISIONARY/
DEMANDING/ARE YOU?
THE 21 BEST JOB OPPORTUNITIES IN THE PHARMACEUTICAL INDUSTRY.
THIS IS EXCITING.CO.UK
PF-DEC-NEWS - EDIT IB.indd 1
PAS not
enough for
Afinitor
Novartis’ Afinitor (everolimus) for the
second-line treatment of advanced
renal cell carcinoma (RCC).
Draft guidance concluded that
Afinitor does not provide enough
benefits to justify its high cost, despite
Novartis submitting an amended
Patient Access Scheme (PAS).
08/12/2010 15:50
Ex-ABPI
Review
chief secures
highlights life
Government role sciences
Former ABPI President Chris
Brinsmead has been appointed as the
Government’s Life Sciences Business
Adviser.
Brinsmead will support close and
collaborative working in life sciences,
both in the UK and overseas, with
the NHS and academia to provide
independent advice and challenge to
Government.
A Government review of private sector
growth has identified healthcare and
life sciences as one of six key business
sectors where opportunities for growth
can be maximised by policy changes.
The review has been welcomed by
industry trade associations, as has its
announcement of measures designed to
follow recommendations made by the
Office for Life Sciences in 2009.
Patent box
holds GSK
key
Chris Brinsmead
New IFPMA
President
David Brennan, Chief Executive
Officer of AstraZeneca, has been
elected as the new International
Federation of Pharmaceutical
Manufacturers & Associations
(IFPMA) President.
Brennan succeeds outgoing IFPMA
President Haruo Naito, President and
CEO of Eisai. John Lechleiter, who
is Chairman, President and CEO of
Eli Lilly, and Masafumi Nogimori,
President and CEO of Astellas
Pharma, have been elected as Vice
Presidents.
GSK plans to invest £500 million
should the Government’s proposed
Patent Box tax regime be established.
The system offers a lower rate of
corporation tax on profits generated
from UK-owned intellectual property
which would fund several initiatives and
could create an estimated 1,000 jobs.
To read the full
story, click on
the headline
Bayer commits
to job cuts
Bayer is to shed 4,500 jobs as part of its
plans for future growth and to enhance
its innovative capabilities.
The company aims to make major
investments in the development of
its pipeline, marketing and emerging
markets by saving €800 million
annually from 2013.
Rebranding at
Bayer
Bayer Schering Pharma has rebranded
itself as Bayer HealthCare.
The decision follows plans to
strengthen the Bayer Group and steadily
reduce the number of its other corporate
brands. Chairman Marijn Dekkers
said the current number of brands has
“diluted” the group and that the change
would improve the company’s worldwide
reputation.
AZ chief
predicts more
cuts
AstraZeneca CEO David Brennan has
warned of further cuts and job losses
within the company.
Brennan says AZ will be continually
looking at its commercial operations for
potential savings insisting “there is more
to go at”.
HAPPY IN THE
WORKPLACE?
HAVE YOUR SAY
Novartis builds on portfolio
Novartis is to build on its
diversified healthcare portfolio
to sustain future growth.
The company plans to
accelerate growth through
its healthcare segments; by
strengthening leadership in
biosimilars and first-to-market
launches to drive performance
in Sandoz; and through
meningococcal vaccines.
Joseph Jimenez
DECEMBER 2010
New public
Novartis
Pharmaceuticals health service
to cut US jobs launched
Novartis Pharmaceuticals Corporation
(NPC) is to axe approximately 1,400
positions.
Imminent patent expiries mean that
its General Medicines US field force
will be cut. But with product launches
expected within the primary care and
momentum within the Specialty Care
business, the company says growth
potential remains strong.
The Government has launched a new
public health service, Public Health
England (PHE) with a budget mostly
to be controlled by local authorities.
The new body will bring together
experts from bodies such as the
Health Protection Agency and will
focus on national health threats
and strategies for improving public
awareness of disease prevention.
EC approves
rare cancer
drug
Pfizer’s Sutent has become the first
treatment to be approved for patients
with pancreatic neuroendocrine
tumours (NET) in Europe.
approved a new indication for the
treatment of unresectable or metastatic,
well-differentiated pancreatic NET
following Phase III trial results.
More cuts at
Pfizer
Pfizer is to cut more jobs than initially
planned.
The company had planned to
reduce its workforce by 15% (over
19,000 jobs), following its $68 million
acquisition of Wyeth last year. But it
now says it expects to exceed its original
workforce reduction target, having cut
numbers by 18,000 up to the end of
Q3.
Andrew Lansley
New twist in
sanofi bid
Sanofi-aventis could see its proposed
acquisition of Genzyme scuppered after
the biotechnology firm entered talks
with rival pharma companies.
Takeover talks began in July but the
pair has been unable to agree a deal.
Media sources claim Takeda, GSK, Eli
Lilly, Johnson & Johnson and Pfizer
have all entered talks with Genzyme.
MabThera
boost for
patients
Patients with advanced follicular nonHodgkin’s lymphoma are set to benefit
after NICE recommended the use of
MabThera (rituximab) as a first-line
maintenance treatment in preliminary
draft guidance.
Evidence showed the drug could
significantly help to delay the growth
and spread of the cancer in those that
have responded to first-line induction
therapy with the drug in combination
with chemotherapy.
NICE says no
Thousands
affected by Roche to Javlor
restructuring
Roche is to cut thousands of jobs as part
of its Group-wide Operational Excellence
Program.
6,300 jobs will be affected, with the
Pharmaceuticals Division, particularly
global sales and marketing, losing more
than 5,000 positions.
bladder cancer treatment Javlor
(vinflunine) in preliminary draft
guidance.
The Institute said the treatment is
too expensive for the NHS and that
manufacturer Pierre-Fabre had failed
to supply suitable evidence of its
clinical effectiveness.
Lundbeck
changes
structure
Avastin not
effective
enough
Lundbeck is to overhaul its sales force
structure.
The traditional sales model will be
replaced by a new structure that includes
Directors of Healthcare Development
and mental health specialists.
NICE has failed to recommend Avastin
(bevacizumab) for metastatic colorectal
cancer in final draft guidance.
NICE said Roche’s Patient Access
Scheme was complex and the drug’s
high costs did not match its benefits.
Roche was invited to submit additional
data, but no new information was
received to justify its costs to the NHS.
No change on
Tarceva
NICE has reiterated its decision not
to recommend Tarceva (erlotinib) as a
maintenance treatment for non-smallcell lung cancer in a second draft of its
guidance.
The independent Appraisal
Committee decided that although
Roche had provided evidence that the
drug could potentially extend life, it was
not sufficiently robust.
NICE favours
diabetes drugs
Patients suffering from diabetes or
heart disease are more likely to receive
new medicines than cancer patients
through NICE’s appraisal scheme.
New analysis showed that between
2007 and 2009 only one out of 23
cancer treatments received a full
recommendation, compared to 4 out
of 7 appraisals for cardiovascular or
metabolic products.
Choppy waters
A recent survey by MGP and Brainsell reveals pharmaceutical advisers and senior medicines
management pharmacists believe the transition to the planned NHS reforms may not be a
smooth one.
T
he White Paper Equity
and Excellence: Liberating
the NHS sets out the new
Government’s strategy for the Health
Service. The intention is to create
an NHS which is more responsive
to patients, and achieves better
outcomes, with increased autonomy
and clear accountability.
One of the central features of
the proposals in Liberating the
NHS is to devolve commissioning
responsibilities and budgets as
far as possible to those who are
considered best placed to act as
patients’ advocates and support
them in their healthcare choices. The
aim is to empower GP practices to
come together in wider groupings
or ‘consortia’ to commission care on
their patients’ behalf and manage
NHS resources.
PAMMtrak is a bi-annual survey
that gathers the views of, and
highlights the key issues facing,
pharmaceutical advisers and senior
medicines management pharmacists.
In October 2010, healthcare
publisher MGP and specialist
market research company Brainsell
carried out a specific survey of this
PAMMtrak audience to assess how
they see the future in the light of the
Government’s White Paper.
The results of this online survey are
based upon the first 100 responses
and make very interesting reading for
those working in the pharmaceutical
industry.
Only 17% of pharmaceutical advisers and
senior medicines management pharmacists
who responded to the questionnaire are positive
about the future under the new commissioning
arrangements; whilst 58% are either quite or
extremely negative. Indeed, more than 80% believe
that their colleagues feel either quite or extremely
negative about the proposed changes.
The new NHS
Only 17% of pharmaceutical advisers
and senior medicines management
pharmacists who responded to the
questionnaire are positive about the
future under the new commissioning
arrangements; whilst 58% are either
quite or extremely negative. Indeed,
more than 80% believe that their
colleagues feel either quite or extremely
negative about the proposed changes.
When asked about their greatest
concerns over the new arrangements,
typical comments included:
“The destruction of the PCT and SHA
organisation and expertise, the loss of
their functions particularly in regard
to quality and patient safety.”
“The proposals to completely
remove PCTs. I agree there is potential
opportunity to make some savings
in management costs but the many
functions and benefits that PCTs
bring to the NHS are I’m afraid going
Pharmaceutical Field December 2010
Quite negative
Extremely negative
Chart 2 - Thinking about the proposed NHS commissioning arrangements, do you think the following
organisations will: (a) have clinical guidelines/care pathways: (b) have prescribing formularies:
80%
Have prescribing formularies
Have clinical guidelines/care pathways
70%
60%
50%
40%
30%
20%
10%
ng
bo
ar
ds
bo
a
ng
m
iss
io
ni
ni
io
na
l
N
at
io
na
Re
g
co
m
io
om
m
iss
lc
P
G
na
l
io
N
at
rd
s
tic
es
ac
pr
P
G
ln
etw
or
ks
Cl
ed
er
a
af
co
ns
or
ti
in
ica
tio
rti
ns
a
sts
tru
co
ns
o
P
G
tio
n
ng
m
co
m
co
m
Re
gio
na
l
G
Fo
un
da
bo
ar
ds
iss
io
ni
ng
bo
ar
ds
es
ac
tic
pr
m
iss
io
ni
ln
ica
in
G
tio
ra
Cl
ed
e
af
rti
P
co
ns
o
P
etw
or
ks
ns
a
so
r ti
co
n
P
G
tio
n
tru
sts
0%
Chart 3 - In which type of arrangement do you think you will be most
likely to be providing medicines management advice
Don’t know
0%
Other (please specify)
10%
Company that you have ownership in
20%
Individual provider
30%
Employed directly by a foundation trust
40%
Employed directly by a GP practices
50%
Employed by a private provider company
60%
Employed by a social enterprise spun out from a PCT
When asked to think about which
organisations under the proposed new
NHS commissioning arrangements will
Neither positive nor negative
Employed directly by a GP consortium federation
Assumed responsibilities
Quite positive
nd
a
“The drug budget being passed to GP
consortiums.”
“It may become fragmented with
individual consortia each taking their
own focus. This may have benefits
if benchmarking and sharing across
consortia are developed.”
“Prescribing teams having to
create their own limited companies
and therefore not being NHS staff.
Working for GP consortia and, again,
not being an NHS employee.”
“Loss of capacity, expertise
and leadership within medicines
management, particularly in primary
care, where the majority of the QIPP
changes (major cost savings) will be
delivered.”
“Greater focus on direct work for
GP practices, budget management,
formulary management, working on
GP agenda rather than PCT agenda.
Employed directly by consortia? More
outsourcing/industry involvement.”
“It will be positive as working with
doctors more closely.”
Extremely positive
Employed directly by a GP consortium
Respondents were also asked: “What do
you consider will be the major changes
to medicines management under the
proposed new NHS commissioning
arrangements?” Typical responses
included:
Chart 1 - Thinking about the DH White Paper Equity and Excellence: Liberating the NHS, how do you feel about
the proposed changes to the structure of the NHS?
Fo
u
to be thrown out with the bath water
and we will have a system in total
chaos.”
“The disintegration of medicine
management services and rising
prescribing costs.”
“Fragmentation, particularly with
respect to medicines management.”
“Medicines management teams
can be quite large in some areas, if
we are to be directly employed by
GP consortia, how are they expected
to pay for the whole team? Will they
want to? Therefore, jobs may be lost.”
“The lack of pharmacy networks if
pharmacy moves to consortiums.”
“That GPs will not sufficiently
comprehend the value of our offering
and choose not to use our medicines
management services but go elsewhere
for them.”
“Uncertainty as to where we will be.
Will there be a role for us and will this
be within the NHS umbrella?”
“Losing my job.”
Chart 4: Under which type of commercial arrangement(s) do you think that you will be working?
70%
60%
50%
40%
30%
20%
10%
0%
Salary
Fee related
to target
achievement
Fee per
project
Percentage of
drug budget
savings
Fee per
month
Other
(please specify)
Don’t know
Chart 5: What will be the main medicines management activities that you are likely to be providing under the
new commissioning arrangements?
Don’t know
Medicines use reviews
Reducing events rates
Care pathway redesign
0%
Formularly development
10%
Cost minimistaion
20%
Prescribing reviews
30%
Formulary management
40%
Managing prescribing budget
50%
Implementing national guidance
60%
Prescribing incentive schemes
70%
Compliance and concordance management
80%
Chart 6: Under the new commissioning arrangements, how likely are you to engage in joint working with the
pharmaceutical industry in the following areas?
Staff training
Patient education
Funding of project staff
Support for guideline implementation
Very Likely
Likely
Economic analysis
Not Likely
Don’t know
Audit
Facilitation of pathway redesign
Medicines management services
Secondments
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
have prescribing formularies, clinical
guidelines/care pathways, and provide
medicines management advice the
results point largely to foundation trusts
and GP consortia/consortia federations.
It is interesting to see that under
the new arrangements roughly 50%
of pharmaceutical advisers and senior
medicines management pharmacists
consider that they will be employed
directly by GP consortia and 28% by
GP consortia federations. Additionally,
roughly a fifth considers that they will
be employed by either a social enterprise
spun out from a PCT or a private
provider company.
The majority of respondents consider
that they will be working in a salaried
post. Although interestingly over 16%
think that they will be working on a
‘fee per project’ basis, over 10% on a
fee related to target achievement and
over 8% on a percentage of drug savings
basis.
From the list of medicines
management activities that they consider
that they will be involved in it would
seem that these will be in managing
the prescribing budget, formulary
management, cost minimisation,
prescribing reviews and formulary
development. More than half also
consider that they will be involved in
care pathway design and implementing
national guidance.
The link with pharma
The respondents were also asked
how likely they would be under the
new commissioning arrangements
to engage in joint working with the
pharmaceutical industry in a range of
activities.
The responses were largely positive
with the leading areas where they would
be likely or very likely to engage with
the industry being training, patient
education, project staff support,
economic analysis and guideline
implementation. Roughly a third stated
that they would be unlikely to engage
with pharma in this way, meaning that
two thirds may be happy to do so.
With the emphasis for commissioning
shifting to GP consortia it seems that
those involved in delivering medicines
management have an uncertain future.
However, this survey suggests that it is
important that companies build strong
relationships with the emerging GP
commissioners and their medicines
management teams and that there is a
strong opportunity to do so.
Transparency
and disclosure:
ensuring fair play
The onset of draconian anti-bribery legislation is forcing pharma companies to review
their compliance policies and procedures. The global crackdown on “white collar crime”
presents one of the biggest challenges to the life sciences sector. Pf explores a new survey of
compliance in Europe. Is your company doing enough?
S
uggestions of bribery and
corruption have hogged the
national headlines in recent weeks,
not least with England’s ill-fated bid to
host the 2018 FIFA World Cup. But
Panorama-style exposés into alleged
inducements are not restricted to the
beautiful game – the issue has been
plaguing the corporate environment
since time immemorial. And pharma,
for one, has never escaped the
insinuation. Earlier this year, Pf led with
news of the US Department of Justice
opening an international investigation
into corruption in the pharmaceutical
industry. Last month, the European
Commission revealed it had carried out
more antitrust raids at European offices
of pharmaceutical companies. Alongside
this, the global industry continues with
rhetoric that places ‘trust’ at the heart
of its collective strategy to improve
its profile with both the public and
customers alike. Yet the sense that there’s
a pharma-Panorama just around the
corner remains.
Next April, new Anti-Bribery
legislation comes into effect in the UK.
Designed to tighten ethical procedures
across the corporate sector, it has been
described as one of the most draconian
anti-corruption laws in the world.
Pharmaceutical Field Decemmber 2010
Crucially, it creates a new offence of
“failing to prevent bribery”, making
businesses with any UK interest
criminally liable if staff, subsidiaries,
intermediaries or “associated persons”
offer bribes on their behalf across the
world. Guilty individuals can face up to
10 years imprisonment. Unsurprisingly,
the new legislation is creating much
unrest in boardrooms across the UK.
Surveying pharma
For sure, the pharmaceutical industry is
sitting up and taking note. A new survey
of European life sciences companies has
revealed high levels of anxiety right across
the sector. The 2010 European Trends
in Aggregate Spend, Transparency and
Disclosure Report, conducted by Cegedim
Relationship Management, found that
93% of respondents are concerned that
regulatory compliance will be a major
challenge to the life sciences industry in
Europe over the next three years – and
that it is expected to impact the industry’s
image significantly. Moreover, the survey
reinforced the view that the challenge of
managing compliance in an environment
where anti-corruption legislation is
emerging globally, will drastically
change the way companies interact with
healthcare providers and customers.
“It came as no surprise to learn that
the greatest concern is the changing
compliance landscape and how this will
affect daily processes and the image of
the industry as a whole,” said Bill Buzzeo,
Cegedim Relationship Management Vice
President and General Manager, Global
Compliance. “Life Sciences companies
need a way to respond to a rapidly
evolving industry that is presented with
stiffer regulatory requirements in addition
to extreme competitive pressures and
market access challenges.”
In response, companies are investing
heavily in compliance and assessing
policies and procedures. But concerns
remain about the need to extend
monitoring beyond traditional sales
The challenge of
managing compliance
in an environment
where anti-corruption
legislation is emerging
globally, will drastically
change the way
companies interact with
healthcare providers and
customers.
and marketing functions. The survey
indicates that European companies are
already looking at what is happening
in the US regulatory environment
as they seek to define and establish
new standards for best practice. Three
quarters of respondents believe that
the methods of tracking promotional
spending currently being used in the
US will be deployed in Europe – but
the report warns that the cultural
differences between Europe and
the US may have implications for
regulators and companies alike. “In
the US, organisations must proactively
disclose a large amount of information;
from violations to every aspect of
healthcare practitioner spend, under
the Sunshine Act that comes into effect
in 2013, specific to 2012 interactions
with healthcare practitioners and
organisations,” the report states. “This
enforcement model reflects the high
levels of regulation and enforcement
applied across every US industry, from
finance to utilities. In Europe, however,
there is a far greater emphasis on
self-policing. Life sciences companies
are being asked by the authorities to
improve information transparency and
provide aggregated spend information.
But at the moment, the final concept
of transparency – and whether it will be
enforced – is still to be determined.”
Broader benefits
Bill Buzzeo
The US is, of course, ahead of its
European counterparts in terms of
anti-bribery regulation. Its market
has been heavily regulated for many
years and the imminent Sunshine
Act makes even greater demands for
spend transparency. In anticipation
of the Act, US companies have made
real progress with their operational
compliance – improving data quality
and regulatory reporting requirements.
Evidence suggests that, as a direct
result, US companies are beginning
to benefit from leveraging the insights
enabled by such data capture, and
sharing information across their
organisations to drive productivity.
In Europe, however, the report
suggests that compliance officers
– where they exist – are still
“determining policy and assessing
the implications of global, regional
and local regulatory requirements.”
In the UK, the ABPI has recently
agreed proposals to update its Code
of Practice to increase transparency
and disclosure – with the changes
coming into effect in 2011. As usual,
the majority of change within the
Code focuses on sales and marketing
– notably the interactions between
commercial professionals and their
customers. But, the report notes,
it is important to gain businesswide involvement in compliance
activity – from senior management
commitment, to the IT people
involved in executing regulatory
compliance programmes and the
business people who own the data.
“In the US, it has become apparent
that the most successful regulatory
compliance programmes are owned
and driven by business people.
Following this model will help
European Life Sciences companies
reduce time to market and the
cost of regulatory compliance,”
the report states. “Furthermore,
growing numbers of US companies
are turning to dedicated third
party solutions for support in the
compliance activity – with around
44% either already using or planning
to take this approach.”
The survey reveals that European
companies are beginning to follow
suit, although in much smaller
numbers. “As the US forges
ahead with operational regulatory
compliance projects, it has become
apparent that managing the
volume of regulatory change and
reconciling diverse data sources
to deliver transparency, is too
challenging to handle internally.
The use of third party providers is
becoming key in adhering to policies
and procedures while effectively
Quick Read
Key findings from the Report
• 83% of respondents work for
European pharmaceutical
companies
• 93% of total respondents
agree that regulatory
compliance will be a major
challenge in Europe
• 82% believe that anticorruption regulation
(Foreign Corrupt Practices
Act, UK Anti-Bribary Law)
will impact the regulatory
enviornment and global
transparency requirements
• 62% agree that the
implementation of
transparency guidelines will
generate promotional spend
decreases
• 83% agree the
implementation of
transparency guidelines
will lead to better resource
allocation
• 53% of respondents
anticipate their investment
in aggregate spend
transparency to grow
• 22% of companies in Europe
are using Excel today to
monitor expenditure. This
is set to drop to 10% as
organisations increase their
dependency on third party
solutions to meet compliance
requirements
tracking aggregate spend, identifying
suspicious financial transactions and
streamlining regulatory compliance
monitoring.”
But there is one area where Europe is
already ahead of the game, at a planning
level at least, namely, leveraging
transparency and aggregate spend
information to derive benefits above
and beyond compliance. 83% agree
the implementation of transparency
guidelines will lead to better resource
allocation; whilst almost two thirds
(62%) agree implementation of
transparency guidelines will generate
promotional spend decreases.
To download a copy of Cegedim
Relationship Management’s 2010
European Trends in Aggregate
Spend, Transparency and
Disclosure Report, go to www.
cegedim.com/eucompliance
Pf YEARBOOK 2010
D I R E C TO RY
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Quintiles – the global pioneer in pharmaceutical services -helps pharmaceutical, biotechnology and healthcare
companies develop and market innovative therapies and services and deliver new drugs and cures for the world’s
most challenging diseases. For more than 25 years, Quintiles has built its work on scientific rigor, therapeutic
expertise and unparalleled service. With offices in more than 50 countries, Quintiles is positioned to accelerate new
therapies to market — ensuring a higher level of healthcare for the people all over the world -,as well as offering
global career opportunities and excellent rewards for our 23,000 employees.
Phone: 01344 601550 Fax: 01344 601035
Emai:l [email protected]
www.quintiles.com
Royce
Royce Consultancy is the premier recruitment agency for the Pharmaceutical, Biotech and Healthcare Industry; we also work
with not for profit and government organizations, offering a bespoke service, tailored to all our customer requirements. We
are proud of our legacy of exceptional career matches, delivered through our award winning consultant team, providing
national coverage and local expertise. We take a consultative approach, deliver a world class service and are the leading
provider of Direct Recruitment and Global Executive Search and Selection.
Tel: 01344 601 144 Fax: 01344 601 036 Email: [email protected]
Contact Kerry Bambrick - Sattar, Director Europe, Royce Consultancy
URL: www.roycejobs.com
Zenopa
At Zenopa we have over 20 years of experience recruiting Sales personnel for the Pharmaceutical industry. Our
client base consists of many of the larger pharmaceutical companies as well as the SME’s in the industry. We
recruit nationally and have offices in Leeds, Buckinghamshire and Scotland. Zenopa are quality assured and
externally audited to ensure we practice “Recruitment with integrity”.
To actively progress your career or to register with us call Zenopa on 01494 818 050.

Pf Yearbook in a PDF format

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