An audience of agencies and pharmaceutical companies and others working in market access gathered at The Royal Society of Medicine for the first PM Society Market Access Interest Group event on 12th June 2018.
Market Access Interest Group
The PM Society Market Access Interest Group (MAIG) is made up of members from both industry and agency. It has three core aims: (1) learning and education; (2) celebrating best practice; and, (3) providing an opportunity to exchange ideas and network. Membership of the group is open to anyone with an interest in market access in its broadest sense, but the Society is particularly keen to hear from industry representatives.
Market access survey results Hassan Chaudhury (Health iQ) and Ram Patel (Brainsell) shared key findings from a recent survey the group carried out to assess members’ understanding of market access, challenges and trends, as well as needs and interests.
There were 104 responses (50% pharma, 41% agency and the remainder from CRO or medical devices). A total of 93 replies were received in response to the definition of market access. The average response length was 23 words (ranging from three words to 87 words). The responses were analysed for common words or phrases and the 10 most frequent phrases were used to come up with the following definition: “Ensuring patients receive appropriate treatment at the right time and right price, working with the local/regional NHS and their processes based on value”. While much of the previous definition was validated by the survey new emphasis was placed on processes differentiating the new definition from the old. It appears as though the definition of market access is shifting as the environment changes and the fluid nature may well be useful.
Full discussion of the survey results is available on the PM Society website here.
The survey will be repeated in June 2018 with similar questions and will also include questions as to how to suit needs/demands. Members are encouraged to participate.
Medicines optimisation looks at the value which medicines deliver. It is about ensuring people get the right choice of medicines, at the right time, and are engaged in the process by their clinical team. Four guiding principles of medicines optimisation help to support a patient-focused approach: (1) aim to understand the patient’s experience; (2) evidence-based choice of medicines; (3) ensure medicine use is as safe as possible; and, (4) make medicines optimisation part of routine practice. By focusing on patients and their experiences, the goal of medicines optimisation is to help patients to: improve their outcomes; take their medicines correctly; avoid taking unnecessary medicines; reduce wastage of medicines; and improve medicines safety [Royal Pharmaceutical Society].
Likened to the parable of the blind men and the elephant, experience and understanding of medicines optimisation can differ between stakeholder; three speakers talked about their perspective: Rob Duncombe (Chief Pharmacist, The Christie NHS Foundation Trust, Manchester), Diar Fattah (Associate Director of Medicines Optimisation, NHS Dartford, Gravesham and Swanley Clinical Commissioning Group [CCG]), and Dr Shirlene Oh (Director of Commerce, Innovation & Capability Development, Imperial College Health Partners).
Optimising the use of cancer medicines: Rob Duncombe
Rob Duncombe talked about medicines optimisation initiatives in place at The Christie NHS Foundation Trust to ensure cancer medicines are used optimally: this involves not only which drugs are used, but also how they are prepared and how and where they are administered. Examples of work to date include:
- dose-banding of chemotherapy as a way of converting an individual patient’s dose to a standard dose in order to reduce wastage of expensive cancer drugs, reduce costs, and increase efficiency, with no impact on the patient outcome;
- introduction of biosimilars into the cancer arena establishing important groundwork to facilitate the introduction of future biosimilars; and
- the introduction of more cost-effective dispensing routes.
In addition, as part of the national NHS England (NHSE) Cancer Vanguard, The Christie pharmacy department has also been instrumental in working with other healthcare providers (The Marsden and University College London Hospital) and industry partners in driving forward innovative ideas to optimise the use of medicines and improve patient care.
Rob moved on to consider next steps in terms of patient experience, evidence base, and safety. He noted that there is a lot more work to be done in terms of fully understanding the patient experience: how information related to that is captured and also how the health service delivers to expectation. Examples of topics to focus on related to cancer treatment included: personalised medicine, optimising treatment in elderly patients; improving delivery methods for chemotherapy; and understanding and managing the complications of newer therapies.
Access to medicines – challenges and opportunities: Diar Fattah
In the second presentation, Diar Fattah discussed the challenges and opportunities associated with access to medicines.
There is strong focus on prevention to prevent spend on avoidable illness by seeing patients more frequently in primary care and promotion of wellbeing; and a move towards whole system thinking (combined budget and holistic thinking). In this respect however, the current set-up often does not facilitate implementation; for example, with different bottom lines healthcare budgets do not encourage primary care spend for secondary care savings. There is a move, however, towards one bottom line with everybody working towards the same goal: achieving best outcomes for patients through more efficient spending.
Diar highlighted the following factors as challenges to access: defining “value” for money: contradicting definitions; cost-effectiveness vs affordability; fragmented structure of disease pathways; many committees; primary vs secondary vs tertiary interface issues; and the impact of Federations.
Variation with regards to the implementation of technology appraisals (TAs), and the need to get smarter. Despite horizon scanning, he highlighted the challenges of finding the funding in a resource constrained system for products with a positive NICE TA. He cited examples of: PCSK9 which has a positive NICE recommendation for the treatment of familial hypercholesterolemia but the uptake of the product has been poor and it has been difficult to identify eligible patients; and novel oral anticoagulants (NOACs), where rivaroxaban had an initially strong entry to market but recent real-world evidence (RWE) demonstrating fewer bleeds with apixaban has seen a shift in the market share demonstrating that RWE plays an important role in terms of longevity.
Market access for high cost therapies innovative and curative therapies. Diar stressed the importance of having early conversations with payers as these products will have a substantial impact on budget and consideration of different approaches to contracting. Citing the example of the Agenzia Italiana del Farmaco (AIFA) assessment of Strimvelis® (GSK) Diar highlighted some solutions to known challenges including; for example, high upfront cost solved with a baseline payment and annual mortgage payments; and, risk share surrounding the uncertainty of effectiveness whereby pay for performance full refund by GSK if a patient requires other treatments after receiving Strimvelis®.
In challenges he commented there are opportunities – new partnerships, innovative contracting. Transparency in terms of communication between stakeholders and early engagement is key.
AHSNs and medicines optimisation: Shirlene Oh
In the final presentation, Shirlene Oh, discussed medicines optimisation from the perspective of the Academic Health Science Networks (AHSNs).
Four AHSN supported medicines optimisation national programmes were highlighted in the presentation. Shirlene presented a case study of the stroke prevention programme to reduce the burden of atrial fibrillation (AF)-related stroke and related mortality. AF can be controlled with drug treatments to prevent further complications, predominantly strokes. Data for outcomes after discharge in people with known AF who are not anticoagulated before their stroke is compelling. Despite this, however, patients with possible undiagnosed AF and those with AF at high risk of stroke who are not anticoagulated are not routinely identified and treated. The AF programme has 3 aims: (1) detect (find more); (2) protect (treat more); and, (3) perfect (treat better). Through collaborative working across the care pathway the programme supports community and primary care to identify those at risk and treat them. You can find out more about the AF toolkit here. The aim is to apply the process that has been used for AF to initiatives in other conditions.
Shirlene highlighted the challenge of trying to retrospectively fit an innovation into the NHS: instead, she stressed the importance of working collaboratively to identify need, and in forming partnerships to identify solutions which in turn help facilitate the adoption of innovations. Shirlene concluded her session by highlighting five lessons learned from work completed to date: (1) take adopters on a journey (commissioner, GP, community pharmacist, nurse, patient); (2) validate in a real-world setting (patient-linked record across settings to make sure understand something about them in the real word); (3) test combinations of innovations to provide solutions; (4) seek longer-term funding (>2 years); and (5) align incentives to provide value for patients, payers, and providers.
Commenting ahead of the panel discussion, Mike Ringe (NHS Engagement Partner [London] and Specialised Commissioning Lead ABPI) added that following the four guiding principles set out in “Medicines Optimisation: Helping patients to make the most of medicines” could facilitate the shift towards a more holistic approach. Moving forward, however, the immediate challenge surround implementation and supporting the introduction of medicines optimisation initiatives / models will be key.
A discussion concluded the session on medicines optimisation with panellists Rob Duncombe, Diar Fattah, Shirlene Oh, and Mike Ringe. Some of the points raised included:
- With the newer high-cost technologies, new challenges will be faced both in terms of commercialisation and how the NHS prepares for their introduction. The panel considered that data will be key: the stronger the data the better. In addition, for the newer therapies high quality real world evidence (RWE) in addition to classical clinical trial data will likely be required. In a potential payment for outcomes model, data and data quality are expected to come under greater scrutiny.
- Regarding the UK's exit from the European Union, the panel were asked to comment what impact they thought this would have on clinical research in the UK. The panel commented that currently the UK is maintaining a competitive position in relation to Europe, according to the Medicines and Healthcare products Regulatory Agency (MHRA) report on clinical trial applications by phase. The panel considered there to be a real risk, however, in terms of supply chains but noted that Industry is preparing and considering contingency plans.
- Putting aside affordability and considering the advancement of technology the panel were asked for their view on what prevents adoption and what might be done to change that? The panel commented that organisational barriers will always be there: changing established behaviour is difficult and organisations need a clear system/s in place to support implementation. Recommendations from the panel were to connect with key stakeholders and to link the innovation to a consequence. The need to support innovation in the NHS has also been recognised by NICE.
- Referencing the Wanless report (2003) which made assumptions about the ability of people to take greater responsibility for their health bringing an estimated saving to the NHS of £30 billion, the panel were asked for their thoughts on the role of the patient in medicines optimisation. In this respect, the panel considered there would be a need for cultural and behaviour change to reverse the expectation that the NHS will “take care” absolving people of the responsibility of looking after own health. Primary prevention; e.g. lifestyle changes was, however, considered key: as a population we do not age healthily. Reference was made to the “Meet MO” videos produced by Wessex AHSN which were produced to encourage and engage patients to book a medicines review with their local pharmacist and GP.
- How often are approaches in other countries taken into consideration in commissioning? In general, do sometimes look to other jurisdictions for learning points but often the question is whether they can be implemented in the UK.
- The current UK landscape was noted as a barrier to incentivising companies to introduce products in the UK, and the panel were asked at what point discussions regarding payment schemes should be initiated. The panel advised to engage as early as possible.
Integrated care systems – evidence for a joined-up approach?
The second half of the agenda opened with a session on integrated care systems (ICSs) introduced by Shirlene Oh. In her presentation Shirlene discussed ICSs and the evidence supporting these models.
Integrated care happens when NHS organisations work together to meet the needs of their local population. Some forms of integrated care involve local authorities and the third sector in working towards these objectives alongside NHS organisations. Research from the Kings Fund has identified three main forms of integrated care: ICSs; integrated care partnerships; and accountable care organisations. An accountable care system is “one in which a group of providers are held jointly accountable for achieving a set of outcomes for a prospectively defined population over a period of time and for an agreed cost” [McLellan et al., 2014].
Integrated care partnerships include a variety of stakeholders; e.g. commissioners, hospitals, GP Federations, community mental health, and local authorities. Each partner signs up to a particular patient journey. Historically partnerships have focused solely on health without recognising the impact of social determinants on health and wellbeing. Shirlene commented that a person may have many interventions in place in terms of care provision; however, if factors beyond health are not acknowledged the provision often does not meet patient need.
The integrated care model aims to increase health gain. In Berwick et al’s “Triple Aim”, three critical objectives to optimise the provision of healthcare and health system performance: (1) improve the health of the defined population; enhance the patient care experience; and (3) reduce the per capital cost of care. Bodenheimer and Sinsky added a fourth aim to improve the engagement and motivation of the workforce – the so-called “Quadruple Aim”. This fourth factor has a key role in achieving integrated care and achieving the primary goal of the “Triple Aim”.
The World Innovation Summit for Health (WISH) reviewed several international accountable care models (McLellan et al., 2014 ). Some models provide more evidence than others: evidence from centres with a like-for-like population have demonstrated reduced expenditure, increased life expectancy, and improved health outcomes. In order to shift the focus towards population health it will be important to take a broader perspective: a challenge in the current model which supports provider organisations. Five key functional components involved in implementing accountable care were identified: (1) define a specified population for which providers are jointly accountable; (2) determine target outcomes for the specified population – importantly these should be outcomes that matter to people in that population, including resource use; (3) develop and define metrics to help determine whether outcomes are improving; (4) restructure payments and other incentives to align with target outcomes (shared risk); and, (5) coordinated delivery of care within teams, across providers and between providers and patients.
Accountable care reforms are in their early stages, and they involve a broad variety of healthcare organizations, populations, and starting points. In the UK, for example, there are still many jurisdictions which don’t receive funding from NHSE to invest in accountable care models. Investment and support to establish these models is key.
A discussion concluded the session on integrated care with panellists Shirlene Oh, Dr Mateen Jiwani (Medical Director, Enfield CCG), and Mike Ringe. Some discussion points included:
- The challenge of moving to an integrated care approach in the NHS with so many different regulators was noted.
- Dr Jiwani commented that the current system is very fragmented where, contractually, different stakeholders have different aims. The reality is that there is not enough resource to fund everyone in the same way so the resource needs to be shared in an equitable way. With integrated care, stakeholders will share finance and common goals. The vision is right but there is much to do to facilitate implementation.
- Pooling risk such that organisations work towards a common goal, should equal greater accountability in the system.
- Setting budgets could be a challenge as the population needs to be defined before the capita budget can be set—need reference spend for a like population and then some means of understanding likely costs.
Question and answer
The afternoon concluded with a panel discussion chaired by Mr Mark Duman (Director, MD Healthcare Consultants Ltd) and included panellists Mike Ringe, Dr Shirlene Oh, and Dr Mateen Jiwani.
Mark Duman opened the Q&A session mooting the idea that, for patients, market access is not just about health technology assessment or formulary access but about “closing the loop”. He queried why, in an outcomes-based system, more is not done in respect of adherence and compliance. Would programmes whereby targets have to be reached for payments (percentage when clinical outcomes in RWE are aligned with those seen in clinical trials; percentage for setting up a patient support programme; and a percentage for research and development); or where patients are asked to sign a contract committing to take a medicine to best of their ability have a place?
Discussion followed on how to incentivise patients to take their medicines. Ultimately it is about ownership of personal health and how invested someone is to respond to a given incentive. Is incentive to improve outcomes not enough? Could payment work as an incentive? Working on the basis of improving outcomes for patients, adherence is the outcome of a positive experience. One suggestion included flipping the current model in which patients visit a GP or other care provider for a service, to a model where the GP or other care provider enters a patient’s life at a certain part of their journey so the patient hosts (a human centred design). Technology is beginning to change things; for example, video conference GP consultations.
In another discussion point reference was made to companion diagnostics – medical device/s which provide/s information that is essential for the safe and effective use of a corresponding drug or biological product – and whether there is scope for companion support programmes where treatment compliance is known to be particularly bad.
Market access is a means of working with stakeholders to make sure the medicine is in the right place within that health economy. Embedding market access comes back to the need to engage and enable someone to go on a journey with you but the main challenge in achieving this is the lack of continuity of care. The introduction of new models of care is challenging: embedding new models takes time and after a few years decommission and change is not uncommon.
The panel commented that there are examples of where integrated care is a success in the UK but noted that more work needs to be done. Shirlene commented that the AHSN run a quarterly learning lab looking at an ICS in another part of the country to understand where they are and commonalities. In addition, the panel remarked that there are some very good Vanguards to reference.
Ultimately patient-centred care may require a cultural change: to change the mindset of the healthcare provider from “fixing a problem” to “creating a positive experience for the patient to facilitate fixing the problem”; and, to change the mindset of the patient in terms of the way we think about health incentivising awareness for personal health from early years.
The meeting closed and was followed with the opportunity for networking.
If you want to know more or to join the PM Society Market Access Interest Group, please contact Helen Eade at firstname.lastname@example.org
Medicines Optimisation - Shirlene Oh
Integrated Care - Shirlene Oh
Overview and other presentations
26th April 2017, Royal Society of Medicine
Head of Procurement, Roche
CEO, Havas Lynx
Partner, OPEN Health
MD, Blue Latitude Health
Carwyn Jones introduced the meeting. This is the first time such a meeting has taken place - procurement and agencies together in an open discussion and hopefully with both sides learning something to improve the procurement-agency relationship in the future.
Justin Lambert – Roche
Global vs Local - Procurement Strategies & Supplier Diversity
Justin Lambert, Head of Procurement at Roche was the first speaker. He has worked in pharma for 15 years, 13 of those in a very globalised company and the last 2 years at Roche which is very decentralised. He started by talking about how the current purchasing environment in pharma is volatile, uncertain, complex and ambiguous. "What's important is that we include smaller businesses into the supply chain" - in other words he advocates "supplier diversity". "This means you get different sorts of people around the table and therefore different conversations".
Supplier diversity is no longer a “nice to have” – it is a competitive advantage
Justin went on to explain the key things procurement teams look for when assessing suppliers or potential projects:
- First is innovation - this is something that's always looked for during a pitch process
- Second there is the economic impact or importance to shareholders
- Third is the management of risk and the importance of compliance
- Fourth is the people, and the need to improve diversity of thought
- And fifth is sustainability - for example a new supplier needs to be able to prove they will be around in 5 years’ time.
Inclusive procurement + Diverse supplier pool = Innovation
The great thing about thinking with an open mindset and including diverse suppliers (eg smaller companies) is that you are likely to be offered a more diverse and differentiated set of solutions. For example you could include companies with local knowledge that are quicker to react and ultimately help with innovation.
Justin went on to talk about how everything at Roche is about putting patients first and procurement is no exception. In fact, in his view, it helps in making the right purchasing decisions if you always ask the question 'how will this project or solution help enable the business to make sure drugs reach and benefit patients?'
One of the questions from the floor was about preferred supplier lists - Justin made it clear that he doesn't feel reducing the size of a preferred supplier list is always right for the business. While some companies are trying to "reduce the tail" of high volume/low value supplier spend, he doesn't feel this is always right or necessary. Ultimately, having a diverse portfolio of suppliers, large and small, is what matters and he feels that just relying on large organisations to deliver solutions will ultimately stifle innovation.
Malik Akhtar - Procurement
2020 Vision of Procurement & What Pharma Procurement Need from Agencies
Malik Akhtar, the second speaker, started by reminding us that there still can be what he called a 'hooligan element' within pharma procurement. It might be stating the obvious, he noted, but buying agency services is not like buying pens and pencils and yet there are still some procurement professionals that try to commoditise marketing services. Malik advocates a "procurement business partner" model. In his experience this has meant that procurement acts more like other functions such as HR, Finance or Legal - where a single procurement professional is wedded to a department or market, gathering detailed business requirements and then bringing in subject matter experts (SMEs) e.g. an expert on media or digital when needed.
Malik had several pieces of advice for agencies; firstly "have confidence in your differentiated product" - you need to show how you are different from your competitors; secondly consider ALL remuneration options when pitching - be creative and consider the "at risk" options; another tip was to remember that in 99% of cases it is not procurement that makes the decision - it's the brand teams. Procurement ensures the team has all the information they need to make the decision but ultimately it's up to them.
Malik presented strong views on when pitching is appropriate. He shared that he doesn't feel that companies should run pitches for what he termed “small projects” as he feels it’s a waste of money on both sides. For smaller projects you should be using your preferred supplier list or incumbent agency and if there are problems with the incumbent, try to sort these out! Pitching should be a last resort.
Malik also suggested that agencies need to "make us (in procurement) look good". He urged agencies to make sure they build relationships with procurement and show procurement what they do. Literally "show us the work" he said, "If we only meet your Finance Director, then we'll only know about your rates".
Controversially Malik urged agencies to "call out bad practice" that they encounter during the procurement process, informing the ISBA (Incorporated Society of British Advertisers) of any bad procurement behaviour, assuming the client they are dealing with is a member. He then asked the audience if anyone had reported bad procurement practice in the past. Of the 80 agency representatives in the audience, a show of hands revealed that while at least half felt they had issues that they would have liked to address, only 2 people had seriously thought about taking these further, and no one had actually done it. Food for thought!
Daniel Roberts - ex-BMS Procurement
The Procurement function’s KPIs and the value they bring to the business and Procurement supplier selection process and strategy
The next speaker was Daniel Roberts - ex-BMS and now a freelance procurement contractor. He talked about the transformation that is happening in procurement, from old fashioned, cost-focussed procurement to a more strategic, creative innovation-focussed discipline. In fact he agreed that procurement and marketing as disciplines, are actually getting closer.
When assessing purchasing options it’s all about ‘value’ and Dan shared a useful diagram showing the 7 elements of value - cost reduction, partnership, cost avoidance, risk mitigation, ROI, cash flow, and positive revenue impact.
He explained that there are now 3 types of procurement approach you may encounter:
- Technical procurement – this is all about cost reduction.
- Traditional procurement – this is cost reduction plus cost avoidance and risk mitigation.
- Strategic procurement – this includes the traditional areas of focus plus ROI, Partnership and Revenue impact.
Procurement are looking for value creation - activities that provide a sustainable competitive advantage. While RFPs traditionally set out to make cost savings, now they are more strategic, focussed on business needs rather than saving money.
There was a discussion of the typical RFP process - a 4 month schedule that starts with internal engagement and desk research in month 1, producing a short list of agencies and drafting an RFP in month 2, the pitch in month 3 and then negotiation and awarding a contract in month 4. But RFPs are costly for both sides and the trend is for less of them.
The procurement department helps break down silos across a business and reduce duplication. So if you have good relations with procurement they can put you forward across the company, acting very much like a facilitator or enabler. On the other hand, procurement is responsible for ensuring the supplier can do the job and so they will seek to “get under the skin” of the agency to check that they can really deliver. Do they have capacity? Is this really their area of expertise?
He shared with us how the performance of procurement professionals is measured - it’s not just about saving money or managing supplier relations; in fact 40% of his performance KPIs while at BMS were about driving business performance and 20% about building diversity for long term growth.
Carwyn Jones (Partner, OPEN Health) and David Hunt (CEO, Havas Lynx)
Carwyn Jones and David Hunt then shared the stage to discuss good and bad examples of procurement-agency relations. Dave shared a very positive story of a client that tried out the agency using a 3 month pilot with clear KPIs, then, when it worked, helped scale the solution across the business. In another example, he explained how a procurement team had coached the agency through a series of unsuccessful pitches so that they learnt from them and eventually won work with the company.
Carwyn talked about one large client where procurement has been instrumental in representing the agency around the entire business and where any issues have always been discussed openly and improvements suggested on both sides. This very “adult” relationship has been positive for the agency team internally and has resulted in everyone wanting to work on that account.
Dave and Carwyn then shared some procurement horror stories – there was a procurement person who ran an RFP process from start to finish with no involvement from marketing, and would not let the agency communicate with the brand team at all. Another procurement department took an agency’s own idea for a project and turned it into an RFP, sending it out to multiple other agencies. Yet another insisted that the acceptance of T&Cs without question was a part of the RFP process. In summary, Carwyn and Dave painted a very mixed picture of pharma procurement, with good stories balanced very much by bad examples.
Finally, the meeting concluded with a panel at which David Hunt was joined by Chris Edmonds (MD, emotive) and Martin Brass (MD, Blue Latitude). There was some disagreement about the extent to which the current procurement-agency relationship needs improving. While all agreed that there were many difficult situations and room for improvement, there was also consensus that there were some fantastic procurement departments that really develop and maintain partnerships with their agencies. The final thought was that it comes down to trust and that all agencies need to make sure they have plans for how they build better relationships with pharma procurement.
“Best in Show” Award won by Ascensia Diabetes Care with CDM London
ViiV Healthcare and Havas Lynx top the category charts
The 31st annual PM Society Awards, announced at the Grosvenor House Hotel on 3rd February to an audience of 950 from industry and agencies, saw a Best in Show award being added to the 18 regular categories. This accolade was won by Ascensia Diabetes Care and CDM London for their Contour Diabetes Solutions campaign. Top of the pharma charts overall was ViiV Healthcare and it was Havas Lynx who stole the show on the agency side. The event was skilfully hosted by Jimmy Carr in combination with everyone’s favourite voice, Alan Dedicoat, the voice of Strictly.
It was the first time for a Best in Show award, following the success of the Winner of Winners award last year which was won by the 2008 Xenical “Butter” ad. The Contour Diabetes Solutions campaign was declared the best of the best this time, as Head Judge Dean Woolley of woolley pau gyro explained. “In selecting this campaign we asked ourselves four questions – Is there a proper idea at the heart of it?, does it answer the brief?, is it beautifully done? and is it something we could all be proud of?. The work by CDM London for this diabetes campaign really hit the mark on all of these”.
Among the main categories, there was a complete change from last year’s results in terms of pharma company winners. ViiV Healthcare scooped 4 Gold Awards and 2 Silvers for their campaign Change the Face of HIV, replacing last year’s highest awarded company Teva. In second place was EUSA Pharma who took home 2 Gold Awards, a Silver and a Bronze for work in support of Caphosol. Other highly awarded companies were Pfizer, Teva, Ascensia Diabetes Care, Sanofi Pasteur and Shield Therapeutics who all received at least one Gold Award plus others in the Silver or Bronze category.
On the agency side, this year’s outright winner was Havas Lynx, who took home 10 awards, matching VCCP Health’s total last year. Havas Lynx was awarded an amazing 5 Golds, for their work in both HIV and Dermatology, as well as 3 Silver and 2 Bronze awards. CDM London and Frontera London took 3 Golds each, with CDM London receiving a total of 7 awards and Frontera 6. Other multiple award winners with at least a Gold included Sudler London (1 Gold, 1 Silver and 2 Bronze), Bedgebury Communications (1 Gold, 1 Silver and 3 Bronze) and VCCP Health (1 Gold and 5 Bronze).
The PM Awards recognise creativity, impact and innovation across pharmaceutical and healthcare advertising and communications. They are still unique in including 5 Target Awards that are judged by nationwide online surveys of healthcare professionals or pharmaceutical executives – the “targets” of the work. Other categories are judged by panels of Creative Agency and Industry experts.
Neil Smith, the PM Society Awards Chairman and man behind the event for the past 17 years said “Following the success of our 30th Awards event last year, I was delighted to see a high level of entries again from a larger range of companies than ever before and the interest in the event as high as ever. As well as seeing some of the long-standing agencies and their clients, it was fantastic to see some newcomers to our list of finalists and winners. We have now fully integrated digital and interactive work into all our categories, and we have robust ways of judging print alongside digital.”
10th November, Royal Society of Medicine
The fourth Digital Works meeting brought together over a hundred delegates from the pharmaceutical industry and healthcare agencies to listen to six experts share their stories on how they are “Proud to be making a difference” within the industry.
Senior Global Multi-Channel Director, GSK
Be More Creative, on behalf of James Holah, Franchise Lead, Shire UK
Digital Marketing Lead, Novartis UK
Head of Professional Relations, Sanofi
Medical Affairs Global IT Account Manager, Eli Lilly
Business Development Director, Health Unlocked
Carwyn Jones – Co-chair and Digital Lead, PM Society
Carwyn started the meeting by welcoming our guests, colleagues and peers from agency and pharma industry.
He reinforced the PM Society’s mission, recapped on current initiatives and welcomed new advocates to join the Society to continue to recognise and promote pharmaceutical excellence within the industry.
He set the agenda for the day and also enlightened us to some interesting facts about our speakers, which for legal reasons cannot be posted online!
Kai Gait – GSK
MyAsthma - Supporting patients in understanding their asthma
Kai opened the first session by presenting GSK’s MyAsthma site which, built over 5 years ago, was designed to support patients via a library of asthma content and tools to score levels of control.
The site had amassed a wealth of content but needed a complete revamp which Kai’s team tackled by analysing how patients were interacting with it and recording their user experience.
From this they set out on an ambitious mission to turn MyAsthma into the most sophisticated and successful mobile health application available, with the platform supporting not just asthma but other GSK therapy areas.
Working in collaboration with physicians from the Nottingham Respiratory Research Unit and The Earthworks, they developed a new framework using the latest mobile technology which allowed patients to input their health data, track and monitor their condition, along with environmental data provided by their phone, which alerted them to potential triggers allowing them to take appropriate precautions. This functionality and clinical support meant the app had to be treated as a Class 1 medical device with all the additional process required for development and approval.
Kai outlined the challenges faced when launching such an ambitious program, given the rapidly growing number of health applications available to smart phone users (currently over 259,000); combining the complexities of the disease area with the continuing development of mobile technology to ensure a quality and trusted app which doesn’t put patients at risk. This is further complicated when building the app on a global level which needs to be approved, deployed and managed at a local market level.
So what was the end result? MyAsthma is GSK’s first Class 1 medical device app and GSK is now the first Pharma company to have created a standalone medical device app. Kai attributes the success to the continual support of a cross-functional team comprising Agile IT, Global Regulatory, IT Risk and Medical & Commercial teams.
Already the data being collected from the MyAsthma app is allowing patients to build a better understanding of what triggers their asthma, helping them to share their data in a simple PDF format with their HCP which has saved up to 20 minutes of consultation time.
Ben Blackmore - BMore Creative on behalf of James Holah, Franchise Lead, Shire UK
Finding a rare patient
Sadly James couldn’t make it on the day but Ben, from bmore Creative, did a fantastic job at the last minute to present Shire’s medical education campaign ‘Bringing Fabry into Focus’.
Ben started by highlighting how challenging it is to identify patients with rare diseases; on average it can take around 16 years of being bounced around the NHS due to confusing signs and symptoms.
Fabry disease (an uncommon inherited metabolic disease) is even rarer and harder to identify and so Shire created an educational tool to help equip their sales force to support HCPs and patients earlier on in the process.
Ben shared the challenges Shire faced due to the usual compliancy regulations, tight budgets and timelines, plus getting access to the KOLs for their input. However they have succeeded in developing a comprehensive app, supported by a website to host a wealth of material which raises awareness of the disease. The interactive tool takes into account a patient’s gender, and then uses different trigger images to launch a relevant version of the Augmented Reality APP that is easy to use and quick to navigate to the different manifestations of Fabry. Built to be displayed in app and replicated online in the website, the content is extremely versatile, allowing it to be tailored to different audiences via different formats.
Ben went on to report that initial user testing has been well received and the tool is already being used at specialist training events for HCPs, 100% sales team engagement and 100% key account engagement. Shire plan to support the app with a marketing campaign using targeted patient emails, increased key AdWords to signpost the tool and potentially launch a social media campaign along with global Shire adoption in 2017.
Daniel Conacher - Novartis UK
Cosentyx Connect Homecare Patient Support Program
Daniel gave us a very insightful presentation into the challenges they have faced with their project CosentyxTM Connect and its access to the market using the Homecare drug delivery service.
This is the first time Novartis had worked within the homecare space so they commissioned some research to identify what their core customers (dermatologists and dermatology nurses) liked / disliked about the service. They then reviewed Homecare providers who were open to working with new processes, along with appointing an agency who could manage the program with the necessary stringent technical infrastructure to support the data management requirements.
The team identified many areas where the process could be digitalised and set to work creating simpler registration forms, developing a central hub for patient records to be stored and the ability for both HCPs and Homecare nurses to access and update with evaluation forms and care plans.
The result was the creation of a sophisticated back end database and front end patient portal where users now have a personalised site they can access to view drug delivery times and schedule nurse appointments along with a wealth of relevant content and advice to help cope with their condition. HCPs have more insight into the care their patients are receiving outside of scheduled consultations which has given them greater confidence in the service.
Daniel highlighted some of the challenges faced when taking on a project of this magnitude, mainly around data protection, management and access of patient records between NHS intranet and Homecare CRM systems and ensuring Novartis had no access to confidential data.
Initial results have been positive, although sign-up has been impacted due to the double opt-in patients need to undertake. They have since identified that hospital pharmacists should also be utilising this service, so are looking to improve the systems further. They are enhancing the patient site, allowing greater user personalisation to give patients access to more relevant content and support groups.
Daniel credits the success of this project with choosing the right agency with the right technical infrastructure and a homecare provider who was willing to change their business model to work together with pharma to make improvements for all to benefit from.
Becky Reeve – Head of Professional Relations Diabetes & Cardiovascular - Sanofi
Teaching HCPs about social media: what we’ve learned
Becky shared with us her very personal journey into teaching HCPs how to embrace social media. She set out in 2011 with the vision of a Sanofi Diabetes Twitter feed; however this is still work in progress! Instead Becky is extremely active on social media under her own personal Twitter account and is on a personal crusade to understand HCPs’ reluctance to engage in this social space.
She spent a lot of time within Diabetes online communities listening to what patients wanted from their HCPs. This gave her a voice to showcase and educate HCPs that patients don’t necessarily want answers but to be listened to. They wanted help in cutting out the jargon and looked to HCPs to share and endorse useful content, apps and support networks. What she has found was HCPs are understandably scared to share content without being certain of its credibility. They have a strong duty of care and don’t want to be personally accountable for advocating information online and exposing themselves to a digital footprint that could hold them accountable and contactable.
This has helped Becky change her mission, no longer does she try and encourage HCPs to take to Twitter and become digital experts, rather she educates them on the growing social media space and helps pinpoint what information patients find valuable, not always scientific but usually more practical advice. Diabetes teams can’t offer patients 24/7 support and the “#doc” is always there, which bridges the gap between appointments.
This still didn’t address the issue of credibility of content, and so https://www.t1resources.uk was created by a group of professionals and patients to help review all diabetes resources, along with personal opinions and blog commentary which flag safety warnings and signposts back to regulated content for clarity. This one stop shop has enabled HCPs to feel more confident recommending this resource to patients, overcoming previous fears of accountability and joining professionals and patients together in helping improve Type 1 diabetes care.
Becky concluded that social media will continue to grow and that HCPs are slowly starting to become advocates, however it isn’t for pharma or HCPs to provide or curate the content, patients are already doing this just fine by themselves!
Ian Hamilton - Eli Lilly
eMIG (European Medical Information Gateway) – industry collaboration backed by EFPIA
Ian made us aware of a collaboration which is underway between the Medical Information Leaders in Europe (MILE) with initial funding from EFPIA to create a European Medical Information Gateway (E-MIG).
This informal organisation was brought about due to the increasing need to help physicians and patients who require medical information find the answers via a self-service portal.
Currently medical information support is being channeled via traditional means; telephone, sales reps, email and post and it is becoming increasingly difficult to manage across the industry. The group recognised that by bringing this online as a collaboration between pharmaceutical companies it could solve the problem, share the cost and ultimately allow improved healthcare decision making on a 24/7 basis.
Currently 18 Pharma companies are participating in this European consortium but Ian is keen to broadcast this initiative and get more pharma companies on board. They are looking to launch in early 2017 and Ian was keen to emphasise that success won’t be measured by the volume of customer visits initially; rather it’s important that this becomes a valued and trusted resource in the industry and helps engage other stakeholders to continue to evolve digital services for the future.
Pamela Penn - Health Unlocked
Health Unlocked – the journey to 2020
Pamela joined us from HealthUnlocked to talk about their established website and how digital initiatives will continue to drive change in health for the future.
HealthUnlocked is the largest social media network for health in the UK. Formed 6 years ago, it identified that although patients need professional advice there was also a great hunger for practical and emotional support. They questioned where patients went to “socialise” and flagged that other social media platforms didn’t address this problem.
And so HealthUnlocked was born, a place to allow peer-to-peer support for patients, caregivers and health advocates to connect online using credible support from organisations and institutions.
Currently with over 600 communities covering 160 disease areas, Pam explained that patient organisations helped to set up and moderate communities and super users and expert patients to help ensure information is kept up to date and accurate.
They found that although patients find websites and apps useful, they especially needed access to local support and so by investing in the latest advances in artificial intelligence and algorithms the site can quickly identify a user and make recommendations based on their location and health journey to help tailor their experience.
Pamela went on to share powerful data to showcase the site; 18 – 30% of patients said they had used professional services less, due to using the HealthUnlocked site to help answer their questions.
The site is continuing to evolve, working with CCGs to localise services available and make patients aware of different communities close to home which could help them holistically across different areas.
They are looking at ways to get HCPs to endorse “social prescriptions”, where drugs cannot be used but signposting patients to HealthUnlocked could help.
Finally they find that many patients are happy to share their experiences and are keen to receive information about medical research, making the site of further interest and potential within the pharma industry.
Digital Works III took place before the PM Society Digital Awards 2015.
A collection of amazing speakers from WebMD, BMS, Search Unlimited, GSK, Boehringer Ingelheim, Veeva, NHS Choices, & M3. These speakers highlighted programmes and initiatives in digital healthcare that have worked as well as fascinating insight and thinking.
We hope you enjoy the content.
Albert Reyes – WebMD: A Day in the Life of a Doctor
Panel Discussion One: GSK and WebMD
David Brooks – BMS, and Matt Lowe – Search Unlimited: Audience behaviour, SEO and Digital PR From insights to insights
Josh Lurie – Symplur: The Launch of Symplur Signals
Panel Discussion Two: Search Unlimited and Symplur Singals
Christian Hansen – Boehringer Ingelheim UK, and Chris Wade – Veeva Systems: Taking the next step how mobile technology remains key to customer success
Martin Moth – NHS Choices: NHS endorsement of Apps - what the future holds
Dr James Quekett – M3 (EU): The value of social learning for doctors
Panel Discussion Three: Veeva, NHS Choices and M3
, Rob Huxford
, Albert Reyes
, David Brooks
, Matt Lowe
, Search Unlimited
, Chris Wade
, Veeva Systems
, Christian Hansen
, Boehringer Ingelheim
, Josh Lurie
, Martin Moth
, NHS Choices
, Dr. James Quekett
, Event Report