I was fortunate enough to have been on the UK launch team for Viagra, and we were desperate to ensure that it was promoted ethically and was given enough space to be taken seriously – as a product that met a genuine patient need. One that impacted on the lives of millions of people.

The press went mad, “sex drug” shouted from every red top. Knee jerk Health Secretary Frank Dobson’s fears about rampant demand introduced restrictions, which clamped down treatment provision resulting in only 17% of those men who would benefit getting a prescription. GPs were told to restrict their prescribing to one pill per week. All driven by fears that the NHS would be swamped by demands for the new drug.

It’s all seems ages ago and now strange to think of a Health Secretary wanting to dictate the sex lives of their citizens. ‘Once a week Dobing’ was laughed at by many, but still acceptable.

The category perceptions changed, and ED was forced into the sunlight. Now discussed and treated  in a very different world. Walking in Soho with Debbie I spied this photo, a demonstration that perceptions change, but somewhere some of your audience remains intransient.  How things have moved on!

My immediate answer was to say, of course they bloody shouldn’t be paid! Treatments are prescribed to make people feel better and help them function in the world, surely that is incentive enough?

Hold on, I thought – it’s plainly not enough. Poor compliance is a fact of mental healthcare. It’s easy to speculate on why these patients would avoid their medication. We need to ask about the conversations they are having with their HCPs. Are professionals helping patients reach an informed decision about treatments?

Well, at least one survey says not really. Here, 59% of patients taking an antipsychotic reported that other treatment options had not been discussed. Almost two thirds said that they hadn’t been given written information prior to starting their medication. And 46% said hey hadn’t been warned about its potential side effects.

The NHS and HCPs need to look at the way they are engaging with patients. How many have read the NICE guidance on patient adherence and choice, published in January? And how is the NHS supporting them in implementing change?

Of course, it’s not easy for anyone. The befuddling thing about informed choice is that patients can refuse medication, and the professional’s obligation is to respect this decision. But what if the individual is antisocial, or a danger to self or others? Why are we paying these guys, really – what are the savings down the line? To make a judgment on this pilot, we need to know more about these patients other than that they are poor compliers.

If the scheme sees the light, bitter laughter will accompany jokes about kids being paid to go to school and likewise to adults for behaving on a night out. No-one’s going to like the idea of a pay-for-peace society. Whatever happens, let’s hope these patients get something positive out of it.

Patientslikeme.com is a privately owned initiative that encourages patients to post details about themselves. This real world, outcome-based data is shared with individuals and organisations who work to improve health outcomes, including pharmaceutical companies, research organizations, and non-profits.

30% of epilepsy patients are refractory to treatment, so this move is good news for patients, HCPs and even competing Pharma. Over 37,000 patients are already registered on the site as well as 3,000 caregivers. Any epilepsy community should include the voice of caregivers, as a significant proportion of epilepsy sufferers are elderly or have learning disabilities.

Patientslikeme.com doesn’t just collect data from patients, it provides quality information and allows them to blog and communicate with peers. It’s a site that really does seem to have patients’ interest at heart. That’s why we like it – and so congratulate UCB for being a part.

Sanofi-aventis to donate 100 million doses of pandemic influenza vaccine to WHO
Sanofi-aventis CEO Chris Viehbacher announced Wednesday that the company plans to make a donation of 100 million doses of influenza vaccine to the World Health Organization to help developing countries confront the influenza A (H1N1) pandemic. Speaking at the Pacific Health Summit, Viehbacher stated that “the future of our industry is linked to the healthcare solutions that will be found for emerging countries,” and added that the donation is being made in support of WHO Director-General Margaret Chan’s “call for common action to fight the pandemic.”

A couple of Sundays ago, my eye was caught by the picture of Angelina Jolie on the front cover of the magazine. She’s beautiful – but more than that I thought there might be a picture of Brad Pitt inside. I was to be disappointed, but what I did find was an interesting – and disturbing – article on the “postcode lottery” pertaining to cancer treatments. I couldn’t believe this was still going on in that Primary Care Trusts (PCTs) have the authority to decide which drugs it will fund for patients in its area.

PCTs hold 80% of the total NHS budget. It is possible to challenge a PCT decision on drug funding – the patient has to demonstrate that he/she is an exceptional case, but this varies from PCT to PCT. I agree with Penny Wilson-Webb CE of the Rarer Cancers Forum that this is a “bizarre and demeaning process”. Imagine being forced to plead for your life by having to demonstrate that you are an exceptional case… what does an exceptional case look like? Is one life more valuable than another? Who decides?

It is astonishing that policies differ so much between parts of the country, and indeed, between neighbouring PCTs. But it’s not just postcodes that make this a lottery. The women featured in this article were middle class, educated; they had a voice. Who speaks for unempowered patients – those who don’t understand their choices, who have little support? A policy of one voice, one rule would solve this.

In April 2008, there was a “dramatic expansion of the patient choice initiative” in the NHS.  Patients referred to see a specialist can now choose their hospital (any that meets NHS standards). However, this doesn’t seem to cover cancer treatments. Why the lottery still?

I felt immensely for the individuals that have been affected by the decisions made by their PCTs. I also felt that doctors had in some way let down patients by not standing up to their PCTs, by not asking the difficult questions. I guess that no-one wants to put their head above the parapet and be seen to be causing a problem… or dare I say it, actually do what they believe to be right in the treatment of patients.

What is clear though is that drug prices will get severe scrutiny, generic drugs will feature heavily in both his and medicare’s planning and he wants an expansion in healthcare benefits to the uninsured. What he is also wedded to is investment in STEM (science, technology, engineering and mathematics). Over the last few years the US as a centre of innovation has been on the wane. Less graduates in science, less investment, less of everything. He has been clear that he wants greater investment in healthcare research, he is a firm believer in biological knowledge and stem and genetic research. These areas will be reinvigorated by his election and with his support the palate for cutting edge research may just be on the turn.

What the real impact of all of this means is anyone’s guess, but if his mantra is true and “change is coming” I sincerely hope it reignites the exploration of life changing research.

You don’t even have to use your teeth.

Here’s the thing: I know this. I’ve tried it. It’s true.

I still peel a banana the hard way. It feels like the right thing to do.

Convincing my friends of this change has been much harder than I thought.

Because it doesn’t feel like the right thing to do, it’ll be a tough thing to teach.

In the healthcare comms business, there are LOTS of bananas … things that people do because of convention, tradition, or simply “that’s just the way things are done.” For example, why is it that we have spent most of our time in Rx focusing on understanding the prescriber and not the uncompliant patient?  Why do ideas always have to be based on an a4 ad format.

The lesson for me is to consider everything we do. Are we making decisions because that’s just the way you’ve always done it? Or that’s the way all of our competitors are doing it? If so, you’re peeling the banana from the “right” end. Pick one of these things and, turn it around to see what happens.

I had a quick browse of OK! yesterday afternoon (dermatology research). The ads in there are graphic and simple. Their feel and message happened to me automatically, without conscious decision. Clarins just stepped right on in there. Bang, I was Gucci’d. But that’s a good thing. I didn’t have to waste time and delve into reams of body copy to know what it is these brands were trying to say to me. The same thing they were saying in their first, second, 500^th print ad. One-dimensional, loud and clear. Intent – a quick reminder of high-end status. (Plus a little eye candy for the logo lover.)

We’d hardly dream of addressing healthcare professionals this way, because we seem to feel we need a myriad of reasons to excuse ourselves. The disease area needs innovating, here’s why, here’s how we help, here’s the whole deal in microscopic detail. Certainly, HCPs need this information – but a brand ad just can’t and shouldn’t carry all of it. Instead, we must communicate quickly the offer/ position in the one elegant wrapper of a creative idea or perhaps like Gucci, a proud identity. To keep our messages simple we can use a separate, successive approach – that’s why we often roll things out in campaigns.

However, healthcare is a major area of research and advancement and that’s why drugs and services are constantly turning over. Research shows that a small amount of inner detail is appreciated by HCPs, so we have room for a couple of clear sentences in our work. OK, our clients are not Gucci, but we can still learn from such brands. Manufacturing processes kept to the label, leather ageing techniques communicated in store, deals kept to a business-to-business environment, and endorsement happens via PR. The ad is left to communicate the feel of the brand as simply and elegantly as possible. Isn’t what really sticks in our heads the stuff we don’t have to think about too much?

To build upon this and make it relevant to our proposition here at Hive. Using the ad to communicate an element of the story, and the whole mix to contribute to a bigger idea which exists outside and above that of the ad concept seems to us to be a better way, and should provide not just a brand feel but a story and richness that contributes to a truer more in depth relationship.

Any healthcare industry observer knows that today’s patients participate more actively in decisions affecting their health than ever before. This is facilitated by a less stigmatised approach to personal health, and by the internet as the ‘premier’ source of healthcare opinion and information.

Aside from some downsides (see previous posts) , most of us see knowledge-empowerment as a promising impact on health outcomes. However, it’s unfortunate that EU citizens are restricted to gaining information online peer to peer (via discussion forums) or from company sites in unrestricted markets, such as the US. This information rarely represents local indications or local market conditions. As a result the patient reviews information that is not always relevant to them, with products that are not always available in their market.

The European pharmaceutical industry has become an outsider to this information exchange. They are legally liable for the products they produce, but prevented from providing a regulated information source to the concerned consumer.

Isn’t it about time that Pharma be recognised as important contributors to health information alongside healthcare professionals, patient groups and regulatory bodies?

The recent European Federation of Pharmaceutical Industries and Associations (EFPIA) call on policy makers to improve access of citizens to medical information seems sensible and long overdue.

The EFPIA have proposed 4 main information categories to clarify the discussion. Firstly, pro-active information, which is provided unsolicited to the public, should be limited to general information on diseases, e.g. covering awareness, prevention etc. but not mentioning specific medicines. Secondly, reference information, covering diseases and medicines, which is sought by patients as in a library, e.g. through the internet. Thirdly, reactive information on medicines in response to enquires received from patients. And finally, support information supplied to support compliance with a prescribed medicine.

The European Commission is also in the process of reviewing the current practice with regard to information to patients on medicines and plans to announce its findings in October 2008.

The European Commission fully supports that better information available to patients can contribute to achieving better health conditions, a more efficient use of resources and better adherence to treatments. And has further concerns over inequalities of information provision across EU members, and the lack of quality standards. In addition to this it also recognises that Member States authorities may not be in a position to fully address patients’ needs in terms of the substance of information and the access via different means.

It would appear that the EFPIA and the European Commission are on the right track and we could expect to see at least a recommendation of harmonisation across member states.

In the mean time consumers of medicines in the EU remain exposed to inaccurate information and at potential risk to their health.

]]> http://hivehealth.com/2008/05/european-patience/feed/ 0 http://hivehealth.com/2008/05/%e2%80%9cit%e2%80%99s-all-greek-to-me-literally%e2%80%9d/ http://hivehealth.com/2008/05/%e2%80%9cit%e2%80%99s-all-greek-to-me-literally%e2%80%9d/#comments Wed, 14 May 2008 10:23:32 +0000 Debbie Cramer http://hivehealth.com/?p=93

A Cambridge University academic is leading a call to dispense with medical jargon in favour of everyday language. Dr Melinda Lyons claims in the Lancet that patients can get dangerously confused by unfamiliar and similar-sounding terms (intra vs inter; hypo vs hyper), particularly in stressful and noisy situations.

This is something to be grateful for, because it’s more proof that healthcare is becoming more patient-focused. While not without its challenges, communication built on the needs and expectations of the end user is clearly the way forward. Dr Lyons’ work, and the fact her research featured in the morning Metro, reminds us that everyone has a stake and a growing interest in what happens in the healthcare world.

But it also reminds us that people aren’t the same. Words that are necessary to one person may patronise another. At Hive we play our part by first understanding who the end user is. Only then can we get the dialogue right between that person and the person looking after them. We do this by letting the HCP know more about who’s in front of them.

It’s a subtle thing, joining the dots between different mentalities and creating proper engagement, but it’s not new in marketing. Without the correct delicacy however, you get a fumbling disaster which tries too hard and fails.

So, between the patronising and the ancient Greek, lies a tone of voice that resonates. Finding it is a beautiful thing.