1. Pf mag @NewPfMag
We can exclusively reveal what @
andyburnhammp would look like if he
crept up on Simon Stevens, wearing a
balaclava.
NHS Wakefield CCG
@NHSWakefieldCCG
#Wakefield, it’s #WorldAidsDay -
there’re various places to go for a
#HIV test, including local
@yorkshiremesmac
Jeremy Hunt @Jeremy_Hunt
What @andyburnhammp won’t tell
you - Labour’s plans won’t raise a
penny for the NHS in 15/16.
Pf mag @NewPfMag
The new emerging British obsession
with prefixing every sentence with ‘so’,
is starting to freak me out. So, can
everyone stop doing it.
Andy Burnham
@andyburnhammp
So @Jeremy_Hunt spoke for over an
hour but couldn’t answer a simple
question: what is he going to cut to
recycle his £700 million into #NHS?
ABPI @ABPI_UK
Our Northern Ireland conference is
over. Thank you to all our delegates and
speakers #abpiconf
Cassius Clay @ThaZenGawd
I’m going back to college... probably
akron university, gonna major in
psychology and minor in sales
management, so I can be a pharma rep
NHS SW CCG @sw_ccg
If you have COPD or asthma then
protect yourself and get your seasonal
flu vaccination as soon as possible
#flusafe
Novartis @Novartis
Retweet if you agree: we need more
support & compassion for people w/
#lungcancer. No one deserves it
Reuters Showbiz @ReutersShowbiz
Take That knock charity Ebola single
off top of UK charts
4 | Pf | DEC 2014
UK public ‘unaware’ of correct
antibiotic usage
A new study has discovered that many
members of the British public do not
understand how to use antibiotics responsibly,
leading to overuse of these vital drugs.
The figures from Public Health England
show that four in 10 people take antibiotics
for minor ailments such as coughs or colds,
which normally clear up on their own and do
not require antibiotic treatment.
1,625 adults were surveyed for the study,
which showed that 90% of people do not
know that bacteria that are resistant to
antibiotics are easily spread from person-to-
person. More than one in seven are unaware
that healthy people can carry these bacteria
and pass them on.
Other findings suggest that many
people do not know that antibiotics are
ineffective against fungal infections and
allergic reactions; that they work as anti-
inflammatories, and that they can weaken the
immune system.
Overuse of antibiotics is now resulting
in the development of antibiotic-resistant
superbugs which means that current
antibiotics will become ineffective, posing a
threat to global health.
Chief medical officer Dame Sally Davies
said: “We need to preserve the antibiotics
we have, otherwise we could see the end of
modern medicine as we know it. This is about
appropriate prescribing by GPs and patients
being aware when antibiotics are really
needed.”
New heart failure drug to get
accelerated EU review
The European Medicines Agency’s
Committee for Medicinal Products
for Human Use (CHMP) has granted
accelerated assessment status to Novartis’
investigational heart failure drug, LCZ696.
The new heart failure treatment, intended
for patients with heart failure with reduced
ejection fraction, is to benefit from an
accelerated European review process which
will allow the CHMP to grant an opinion
after 150 days instead of the normal 210.
Accelerated review status is seldom
granted and has never before been awarded
to a cardiovascular therapy. A decision
on EU approval is now expected to arrive
during 2015.
The regulatory submission will be
based on results from the largest ever
landmark study conducted in heart failure,
PARADIGM-HF. The results showed that
LCZ696 can significantly reduce the risk
of cardiovascular death or heart failure
hospitalisation compared to an established
alternative.
David Epstein, division head of Novartis
Pharmaceuticals, said: “Novartis is
committed to extending and improving
more lives sooner with LCZ696, and this
decision by the CHMP we hope will greatly
support our effort to do so in Europe.”

2. One in ten GP practices under
‘intelligent monitoring’risk
Pf | DEC 2014 | 5
General News Personnel News NHS News Drugs News
Funding award for pioneering UK
asthma research
Dr. Andrew Wilson from the University of
East Anglia has been awarded £1.7million in
funding from the National Institute for Health
Research (NIHR) for research into reducing
deaths from asthma.
The money will enable the Asthma UK
Centre for Applied Research to identify people
most at risk of an asthma attack in order to
reduce the high number of avoidable asthma
deaths.
The research comes at a critical time,
following the publication in May of the
National Review of Asthma Deaths by the
Royal College of Physicians. The review
identified that as many as two thirds of the
three deaths caused by asthma every day in the
UK could have been avoided.
In many cases the warning signs were
ignored and more than two thirds of people
hospitalised in the month before they died did
not get properly checked up afterwards.
Past asthma attacks are a clear risk factor for
future attacks and everyone who is hospitalised
due to their asthma should see their GP
within 48 hours of leaving hospital. However,
Asthma UK’s Compare Your Care report
2013 discovered that three quarters (74%) of
people with asthma did not have a follow up
appointment.
Dr. Wilson’s research will examine
whether introducing a register of people
at risk of an attack and training medical
staff to provide these patients with ongoing
specialist support will reduce their likelihood
of being hospitalised by asthma or suffering a
potentially life threatening asthma attack.
The research is a key part of the Asthma UK
Centre for Applied Research, a collaborative
partnership of 13 of the UK’s leading academic
organisations. Their work includes halving
the time that it takes to develop new asthma
medicines and treatments through clinical
trials that lead directly to improved care.
Dr. Wilson, based at the University of East
Anglia, said: “Identifying and targeting care
to patients most at risk of asthma attacks and
developing methods to deal with the variable
standard of care in the UK are important
national treatment strategies.”
Findings gathered by a Care Quality
Commission (CQC) report have revealed that
one in ten GP practices have been assigned
the highest category of risk in an ‘intelligent
monitoring’ system.
The report showed that one in 10 GP
practices posed the greatest perceived risk in
an intelligent monitoring system devised by
the CQC.
The report used 38 different indicators to
determine the perceived risk of each practice
in England, with each practice assigned one
of six risk ratings with one representing the
“greatest perceived risk” and six the lowest.
The 900 practices categorised as band one
will be first in the queue for inspections next
year, the CQC has said.
The report also showed that there was
also considerable regional variation in the
proportion of practices falling into the lower
bands. At least four in five practices fell into
the four lowest bands.
Only 4 per cent of practices in the North
East were rated as band one or two, while 20
per cent of London GP practices fell within
these rankings.
One of the main reasons cited for practices
being pushed into the lower bands is the
difficulty of access to their GP or practice
nurse.
Oxfordshire commissioners have failed to
submit a realistic better care fund plan to
NHS England, which rejected their proposal
on the grounds of its incomprehensibility.
The proposal, submitted in September,
failed to meet NHS England’s assurance
process for the programme.
The county’s better care fund plan was
one of just five across England which was not
approved last month. Other unapproved plans
were from Essex, Lancashire, Hillingdon,
and Northamptonshire Care Commissioning
Groups (CCGs).A statement fromOxfordshire
CCG and the county council cited a number
of reasons why the proposal was rejected,
including: “our new focus on commissioning
health and social care services via outcomes-
based commissioning, the timescale for which
crossed over with those for the submission of
initial better care fund proposals.”
The organisation also said that the plan
did not meet national requirements, which
expects “emergency hospitals admissions to be
reduced”, despite hospital admissions rising
locally and nationally.
The statement concluded: “The clinical
commissioning group and the county
council are working hard with Oxford
University Hospitals Trust and Oxford Health
Foundation Trust to address the challenges
and issues regarding the implementation of the
better care fund principles.”
Oxfordshire CCG has already spent the
past year redesigning its proposals to introduce
integrated outcomes-based contracts for adult
mental health and older people’s services.
The ambitious scheme attracted controversy
a year ago when both local trusts publicly
expressed serious concerns over its potential
impact.
Oxfordshire’s
better care fund
plan rejected

3. ABPI report shows relative lack of UK
access to innovative drugs
New research published by the Association of
the British Pharmaceutical Industry (ABPI)
shows that fewer patients in the UK are
receiving new, innovative medicines than the
average in a range of comparable developed
countries.
The research showed that the UK uses
branded medicines less per person than many
other countries but tends to use older rather
than the latest medicines.
The report, International Comparison of
Medicines Usage: Quantitative Analysis was
compiled by the Office of Health Economics
(OHE) and updates the 2010 Richards Report
which examined the extent and causes of
variations in international medicines use.
Despite showing an increase in usage per
person for 11 of the 16 therapy classes surveyed
from 2008/09, the report demonstrates that the
UK occupies the 9th place out of 13 countries.
France maintains its position at the top of the
rankings while New Zealand remains in
13th place.
In seven of the 11 therapy classes the UK
usage per person was below the international
average for 2012/13. Usage included the latest
cancer medicines less than five years old and
those for dementia, multiple sclerosis and stroke
prevention.
In the remaining four of these 11 classes
– cancer medicines more than 10 years old
and medicines for osteoporosis, respiratory
distress syndrome and wet age-related macular
degeneration – UK use was higher than the
international average for 2012/13, highlighting
a reliance on older medicines and relatively slow
uptake since 2009 of newer, more innovative
medicines, to treat cancer in particular.
David Watson, the ABPI’s Director of
Pricing and Reimbursement, said: “We will
use the information in this report to continue
discussions between industry, the Department
of Health and the NHS on how access to
medicines can be increased through the
commitments of the PPRS (Pharmaceutical
Price Regulation Scheme) agreement.”
6 | Pf | DEC 2014
Patients‘unaware’
of GP out-of-hours
facilities
A report by the Public Accounts Committee
has revealed that people do not know where
to turn to when GP practices are closed
amid ‘unacceptable’ variations in the quality
of out-of-hours services.
The report has shown that “complex and
fragmented” systems mean patients are left
confused about where to get help, resulting in
higher numbers of Accident and Emergency
cases.
Health officials have been accused of failing
to provide the basic information necessary to
guide patients to the appropriate help for their
need.
Despite the number of services available,
including out-of-hours services, walk-in
centres, urgent care centres, or the NHS’s 111
service, patients are still not clear on what
service would be appropriate for their illness.
The report has also accused NHS England
of lacking the basic information necessary to
say if there will be enough GPs in the future
to deal with the growing workload expected.
The Committee’s Chairman, Margaret
Hodge, said, “Patients’ experience of, and
satisfaction with, the out-of-hours services
varies significantly and unacceptably across
the country, as does the cost.”
She said that too many people were
unaware of the different urgent care options
and how to contact them. “This means people
may not receive care in the most appropriate
setting. As a result of the confusion, too may
go to A&E when they do not need to.”
The report also found that one third of
adults in England had not heard of NHS 111
or do not know what it is for.
One quarter had not heard of out-of-hours
GP services, with a lower awareness among
certain groups including younger people
and people from black and minority ethnic
communities.
NEWS
North Staffordshire - CCG leaders
have said any plans to remove the
existing organisations, who treat cancer
patients in North Staffordshire will be
carefully considered by the board, amid
growing fears from the public over the
controversial tendering out of £1.2 billion
of cancer and end-of-life care in the
county.
North Essex - Chief Clinical Officer of
the CCG, Dr Shane Gordon, has said
North Essex CCG is under “considerable
financial and operational strain” if the
soaring population growth, which is
expected to rise to by 10,000, continues
over the next ten years.
South Devon and Torbay - South
Devon and Torbay CCG has defended
itself against the findings gathered in the
GP Patient 2013-14 survey, which claim
that nearly a fifth of local patients cannot
see their GP within a week of trying to
make an appointment.
Scarborough and Rydale - A new urgent
care centre will be integrated within
Scarborough Hospital’s A&E unit, the
CCG has announced. The service is
expected to replace the walk-in service at
the Castle Health Centre in York Place.
Cambridgeshire and Peterborough - A
report compiled by the CCG has revealed
that Addenbrooke and Rosie hospital has
experienced “significant problems” with
its Epic eHospital system – a £200m
electronic patient record system.
Waltham Forest - Doctors are urgently
asking people to use the NHS 111 service
before visiting the hospital in order to
reduce the strain put on A&E staff during
one of the busiest times of the year. It
has been predicted that forty per cent of
visitors to Whipps Cross Hospital’s A&E
department this Christmas could be seen
by a regular GP.

4. Results from a survey commissioned for
the 3rd annual Healthcare Meetings Forum
(HCMF), aiming to define the link between
scientific information and positive patient
outcomes, has shown positive trends for the
future.
The 400+ results received so far from health
care professionals (HCPs), which have been
evaluated by the HCMF steering committee,
offer positive views. 75% of respondents said
that they preferred face-to-face meetings, as
opposed to questionnaires conducted online,
especially if it related to securing patient
outcomes.
The results are encouraging and provide
a strong catalyst for discussion at this year’s
Forum: ‘Focus on the Patient – Driving new
trends for medical meetings’.
The survey also showed that approximately
three quarters of respondents believed that they
would receive 80% of medical information
virtually by 2017. These results directly
impact the structure of medical meetings
and in-person
attendance,
particularly as
more research
and seminars are
published digitally, as well as coping with busy
working schedules and diminishing budgets.
Changing the nature of information sharing
is to be addressed at the Forum meeting,
focusing on the quiet revolution in medical
congress formats and delivery methodology.
The meeting will also answer the question of
how content is best delivered.
Other results to come out of the initial
responses show the significant minority of
those who believe that healthcare companies
can speak directly to patients about their
products (19%).
Responses to the survey are still being
received by the HCMF steering committee
and this year’s Forum promises to reveal
more insightful and significant data, through
leadership and a frank forum for discussion.
Healthcare Meetings Forum 2014
survey yields key trends
High blood
pressure giving the
NHS high bills
Figures released by Public Health England
(PHE) have revealed that diseases caused by
high blood pressure are costing the NHS vast
amounts of money.
Following data published by PHE, the
organisation has announced it will partner
up with the local and national government to
tackle the expensive burden posed on the NHS
caused by patients requiring treatment for high
blood pressure.
As a result PHE has devised a plan of action,
including allying with the government, as
well as the health service, voluntary sector
and academia to better manage spending for
patients who require treatment for illnesses
associated with high blood pressure.
The action plan will set out steps towards
emulating the success of other countries, such
as the US and Canada, in achieving higher
levels of treatment and better control of high
blood pressure, leading to lower death rates
from heart disease and stroke.
Increased demand has put pressure on the
NHS to cope with diseases related to high blood
pressure, which has been estimated to cost the
health service more than £2bn every year.
High blood pressure, also known as
hypertension, can increase a person’s risk of
a heart attack or stroke, and is often dubbed
the ‘silent killer’. Figures continue to rise, with
the condition affecting more than one in four
adults in the UK.
Despite the heavy burden already weighing
on the NHS, there are still a further five
million people in the UK who are unaware
that they have high blood pressure.
Responding to the report and the action
plan, Public Health Minister Jane Ellison said:
“Any new initiative which will improve people’s
health and wellbeing as well as saving the NHS
money is to be applauded.”
Pf | DEC 2014 | 7
The Association of the British Pharmaceutical
Industry (ABPI) has welcomed George
Osborne’s announcement that the rate of
research and development tax credits is due to
increase.
ABPI Chief Executive Stephen Whitehead
hailed the “beneficial impact” of the decision,
which was announced in the Chancellor’s
autumn statement.
“I welcome the Chancellor’s decision to
increase the rate of Research & Development
(R&D) tax credits for both smaller and larger
firms which will have a beneficial impact
on business investment in the UK. The
pharmaceutical industry is a key contributor to
the UK economy and a leading manufacturing
sector.”
Mr Whitehead however expressed concerns
about an additional statement from the
government which may indicate changes that
adversely affect R&D investment:
“Our industry employs 73,000 people
directly in the UK and invests £11.5million per
day on R&D. We are concerned however that
proposed changes to the Patent Box outlined in
a written ministerial statement yesterday may
affect incentives for investment in R&D.”
Mr Whitehead went on to underline the
role that the ABPI will continue to play in
facilitating access to the latest innovations in
medicines, in partnership with the NHS and
other stakeholders:
“I am also pleased to note that the
Chancellor has allocated increased funds to the
NHS at what is a challenging time. The ABPI
is acutely aware of the funding issues facing
the NHS and the pharmaceutical industry has
done its part by underwriting the medicines
bill within agreed boundaries under the
Pharmaceutical Pricing Regulation Scheme.
This is a platform for patients across the UK to
get access to the latest innovative medicines.
“The ABPI is committed to working with
all stakeholders to ensure that we can foster
the best possible environment in the UK
incorporating a holistic industrial strategy so
that the pharmaceutical industry can continue
to flourish.”
ABPI welcomes increase in rate
of R&D tax credits
General News Personnel News NHS News Drugs News

5. 10 | Pf | DEC 2014
DIAGNOSIS
T
he NHS is one of the biggest
employers in the world,
rivalled only, it is said, by
Indian Railways, Wal-Mart,
and the Chinese People’s
Liberation Army. Its more than 1.7
million employees include about 370,000
nurses, 106,000 hospital and community
medical and dental staff, 40,000 general
practitioners, and 19,000 ambulance staff.
The NHS’s annual budget is about £110
billion, about £65,000 per employee; the
drugs budget is about £14 billion. There
are about 240 million patient consultations
per year, of which 80% occur - in general
practice - at about £25 a time, and 20% in
secondary care, at about £2800.
UK universities employ under 25% of
that number: 383,000 people, of whom
186,000 are academics. Total annual
expenditure is about £28 billion, about
£73,000 per employee.
It is difficult to include drug companies
in such comparisons, because they
are multinational, and UK employees
contribute only part of the overall
endeavour. Furthermore, many very small
companies, including university spin-
outs, contribute to varying degrees, for
example, in early drug development - before
passing on new compounds to major drug
companies. As a touchstone, however,
Abbott Laboratories, AstraZeneca, Bayer
HealthCare, GlaxoSmithKline, Johnson &
Johnson, Merck, Novartis, Pfizer, Hoffman
la Roche and Sanofi-Aventis together
employ about 900,000 people. They spend
an estimated £33 billion each year on
research and development, and about twice
that on marketing, with total expenditure
being in excess of £110,000 per employee.
The interrelations in this tripartite
structure are complex. Results of research
by NHS and University academics can
be used by companies in drug discovery
and development, and can be harnessed in
spin-out companies. Recent examples of
innovations from Oxford include analytical
platforms for genomic sequence data
analysis and novel methods for synthesizing
individual isomers of chiral compounds.
Academic and NHS clinicians conduct
clinical studies of new compounds at
all phases of development and may use
the compounds as tools in their own
research. They sometimes act as consultants
to companies, advising on aspects of
development. The same academics may
then advise regulatory agencies - such as the
MHRA and NICE - about the acceptability
of the medicines in clinical use, while also
teaching other students and doctors.
Drug discovery
Erstwhile methods of drug discovery,
which focussed on biological systems, have
given way in recent years to an intensely
target-driven process, which I have called
‘targetophilia’, and others ‘targephilia’,
but which I prefer to call ‘stochophilia’
(Greek stochos = ‘target’ and ‘guess’; cf,
“stochastic”). Much of the single-target low-
hanging fruit, however, has been picked.
It is not, I believe, coincidental that
this same period has seen an increasing
number of failures in drug development,
particularly during phase II, increasing
emphasis on the marketing of stereoisomers
and novel formulations, which are not in
themselves highly innovative. Furthermore,
many companies have disinvested in areas
previously thought to be potentially fruitful.
Both pharma and the universities could
consider the potentially beneficial effects
that could accrue from a return to a systems-
driven approach, and a search for innovative
medicines with multiple mechanisms of
action. This could be facilitated by the
establishment of Institutes of Drug Discovery
and Development, whose activities could
include development and implementation of
translational pharmacology research. They
AGAINAGAIN

6. could also draw on the collective expertise
of academic clinicians and scientists, while
liaising with corporate partners to facilitate
collaboration, knowledge transfer and
effective translation.
Transparency
Changes in societal attitudes to
transparency have markedly affected the
relationship between big pharma and big
medicine over recent years. Companies
have, in some cases, withheld evidence
that might adversely affect perceptions of
the benefit-to-harm balance of a medicine.
This has started to change with advance
registration of trials and declarations,
with some companies agreeing that they
will make all the evidence available and
have individual patient data srcutinised
in clinical study reports collected during
randomised studies. This has also been
extended to transparency in animal
experimentation by groups such as
CAMARADES.
The All Trials campaign, to which
over 80,000 individuals, and over 530
organisations have subscribed, has been
instrumental in pressing for increased
transparency. Another aspect of this is the
stated willingness of some companies to
declare moneys paid by them to named
healthcare professionals. All this should be
universal.
Funding
From time to time companies have funded
training posts in universities, but these
have declined in recent years for financial
reasons. The disparity between funding of
drug companies and universities, however, is
enormous, while the latter punch way above
their weight in contributing to drug discovery.
Major drug companies should be prepared to
fund academic posts.
Particularly pressing is the need for
basic and clinical pharmacologists, who
have in the past been instrumental in drug
discovery, facilitating decision-making
during drug development and introducing
new therapeutic applications (e.g. the use of
beta-blockers in hypertension, first described
by Brian Pritchard, and of acetylcysteine
in paracetamol overdose, pioneered by
Laurie Prescott). Meanwhile, the detecting,
reporting, and interpreting of adverse drug
reactions, and the teaching of careful, safe and
effective use of medicines remain pivotal.
Currently in the UK there is about one
clinical pharmacologist for every million
of the population; contrast this with, for
example, Croatia, where the ratio is about
one to 150,000. Currently many of those
who hold the title of clinical pharmacologist,
within companies, are not clinically
qualified, and although this is not a huge
disadvantage in the early phases of drug
development, it becomes problematic in later
phases. Companies should seek partnerships
with universities in training clinical
pharmacologists. Secondments for longer
periods than have been usual in the past -
e.g. five years, rather than one year - would
be mutually beneficial.
For their part, the universities should
seek to have the restrictive influence of
research assessment exercises waived for
individuals who are seconded, to encourage
fruitful academic career paths when they
return to academe. Some among those
who are seconded will choose to stay in the
companies anyway.
The NHS is in a financial crisis and
cannot currently afford to take part in the
large high-quality clinical studies that are
necessary for successful drug development.
Drug company funding, aimed at training
clinical trialists in the provision of
hospital-based clinical investigation units,
could help mitigate this. The increasing
tendency of drug companies to fund
work of this sort abroad, more cheaply
purchased, has militated against such
developments in the NHS. More funding
of research in general practice could be
achieved by funding GP trainees to do
clinical research.
Different types of clinician–researcher–
teachers, independent of drug companies,
could be funded through different types
of collaborations involving corporate
partnerships.
Patients
The whole purpose of all this is, of course,
to serve patients and provide them with
medicines for which the benefit-to-harm
balance is highly favourable. Patient
expectations of the benefits that medicines
can bring, however, have increased markedly
in recent years and adverse reactions have
become less acceptable. Nevertheless,
patients are still not well informed in this
area. Drug companies should seek to provide
clear patient information, moderated by
independent academics, rather than by
company members.
This also applies to the education of general
practitioners. Most teaching and training
in therapeutics and prescribing occurs in
hospitals, but 80% of all prescribing occurs
in general practice. Better education and
information should also allay the fears
recently voiced about the sharing of patient
data, through large databases, with drug
companies.
Conclusion
However much big pharma is feeling the
financial pinch, UK big medicine is much
worse off. The former should be giving more
unrestricted, no-strings support to the latter,
pursuing the common aim of discovering
innovative, clinically effective, and cost-
effective medicines, while also galvanising
healthcare.
Jeff Aronson is a clinical pharmacologist
and honorary consultant physician in
Oxford. He is a President Emeritus of
the British Pharmacological Society
and Editor of Meyler’s Side Effects
of Drugs: The International
Encyclopedia of Adverse Drug
Reactions and Interactions.
AUTHOR
Jeffrey K Aronson
Pf | DEC 2014 | 11
“The All Trials campaign,
to which over 80,000
individuals, and over
530 organisations
have subscribed, has
been instrumental in
pressing for increased
transparency”

7. S
ince 2001, Pf’s Company,
Perception, Motivation and
Satisfaction Survey for the UK
medical sales force industry has
been gathering and dispensing
information like a maniacal Amazon drone on
Black Friday.
As we prepare for another festive season
- by pulling the decorations down from the
loft, scribbling cards to our favourite second
cousins (once removed) and blowing the dust
off Grandma’s favourite sherry – questions
begin to emerge. How can I see what
professional progress I have made, am I in
the right place at the right time, or should I
be making plans for the new year? It’s funny
you should ask that, as the answers lie right
here, illuminated by a twinkling string of
fairy lights that metaphorically represent the
sparkling Pf Survey.
A festive feast of pharma
As any good cook will tell you, the
preparations for the finest Christmas puddings
begin months before the big day. We’ve gone
one better than that – our pharma sales treats
have been in the making for years; 14 of
them, to be precise. We’ve gathered together
the opinions of pharma sales and marketing
professionals, mixed together the assorted
opinions, added the tastiest views, drenched it
in enlightening insights, thrown in a sixpence
for good luck, then steamed and served it
up to you with a generous deposit of brandy
butter.
The annual Pf survey has run every year
from 2001 to the present. A lot of data
has been crunched by our industrious and
enthusiastic band of elfs during this glorious
time. Just shy of 19,000 questionnaires
have been completed on paper and online
since the survey began in 2001. Meanwhile,
950,000 individual elements of data have been
organised and analysed; representing little
baubles of brightly shining, jewel-coloured
insight into where the pharma sales industry
has been, where it is now, and where it’s going
in the future.
Talking turkey
One of the most significant discoveries
unwrapped by the survey every year is the
verdict on the favoured ‘Employer of Choice’
- the category in which employees cannot vote
for their own company.
There’s no better yardstick for measuring
a company’s true worth than through the
eyes of industry personnel. Therein lies the
truth – just as Scrooge’s treatment of his
long-suffering employees was laid bare by
those candid Christmas ghosts, so the Pf
Survey hovers over the shoulders of pharma
firms like a rather more benevolent, but no
less enlightening spirit, showing them exactly
what staff elsewhere think of their cultures,
products and working environments.
Every year survey respondents are asked to
score a selection of approximately 45 medical
sales companies, with regard to the perception
of how desirable they are to work for, from an
external perspective. A five point scale of very
low (total turkey), low, neutral, high, very high
(golden goose) has been used every year, with
a blank score indicating no overall perception.
Time and again, three companies have
topped the list of desirable pharma firms.
Since 2007, Boehringer Ingelheim has
occupied the number one place in the
Company Perception results. Like a combined
Slade, Wizard and East 17 Supergroup it, once
again, stormed to the top of the Christmas
charts in 2014. Not just a crown, but the full
bird, Boehringer Ingelheim won the race to
the summit fair and square. Indeed, since
2008 the firm has consistently attracted the
least amount of negative perceptions and the
highest number of positive perceptions.
Speaking of second place, Roche has been
sitting pretty like a pig-in-a-blanket at the
number two spot for six years out of seven,
where it remains to this day.
SURVEY
MAK
E
A DIFFER
ENCE
2001 - 201
SURVEY
Tear open the gift of Pf Survey 2014 results – we may
not have the glamour, sequins and fallen celebrities of
‘Desperately Been Dancing’ (to save my career), but
we can guarantee all the wit, saucy rhymes and cultural
insight of The Two Ronnies Christmas Special.
18 | Pf | DEC 2014
SPONSORED BY

8. Also this year, Janssen pulled a cracker as it
nudged Lilly aside to take up third position,
showing that it is increasingly becoming
pharma’s Christmas present of choice.
Not only has Boehringer Ingelheim
consistently carved up the competition, but
prospective employees have continued to
hover longingly outside their windows like
Tiny Tim, hoping and praying that some of
the good times could one day be theirs. In
2012, 2013 and 2014, survey respondents
were asked which pharma company was their
preferred destination and the reason why.
The jingle bells and merriment at Boehringer
Ingelheim effortlessly achieved the number 1
ranking for this investigation as well, proving
that - like all good traditions - it’s all about
reputation, credability, evolution and, above
all, impressive results.
Jingle bells
In order to ensure that its employees will
be ringing in the New Year at their usual
manger, instead of defecting to another
cordial host, pharma firms need to place a
number of gifts under the tree, and not just at
Christmas.
As you generously give, so shall you receive.
According to our survey, the gifts of job
security, salary, bonus, personal development,
training, belief in present products, future
product pipeline and structured appraisal
system were reported as being the most
desirable.
While everyone loves the thrill of opening
a card to find a crisp note fluttering out,
money isn’t the most important motivational
factor for our respondents. Some of the
best gifts that a successful company can
offer employees, to excitedly unwrap, are an
excellent company culture, good pension
scheme, healthy work/life balance and a
good relationship with their direct manager.
Nice stocking fillers include a company share
scheme and good car policies.
Yule like this
The Motivational Values section within
the Pf Survey serves as a benchmark
for those things that keep pharma sales
professionals, all across the land, willing
to clock in promptly every day. The most
important motivational factor is still that
vital wedge, with salary continuing to
rock at the top of the motivational pops
in 2014.
In 2013, ‘job security’ and ‘relationship
with manager’, dived onto the sofa, beside
the dosh, slotting into second and third
positions respectively. In 2014, however,
‘relationship with manager’ has been shunted
into fourth place, as ‘work-life balance’
became employee’s third most wanted
present (not unlike socks and slippers in
that respect), proving that these days it takes
more than ‘nine-to-five’ to create a happier,
more motivated employee. Interestingly,
throughout the survey’s history this factor
has consistently appeared in the top three
motivational work factors, taking the silver
position in 2003 and 2007, before this year’s
triumphant return.
It’s a wonderful life
As we hurtle towards the year of Our
Lord 2015 it is clear from our survey what
respondents want – in addition to peace on
earth - a superior salary, secure job future and
a healthy balance between work and home
life. All pharma companies are united in their
desire to retain their best employees, and will
be keen to deliver abundant gifts in the New
Year. In a rapidly changing environment the
need to keep staff inspired, motivated and
prepepared has, perhaps, never been greater.
Once again, the Pf Survey has provided
a great gauge with which to judge how
companies are performing in these vital
arenas. What will next year’s reveal?
AUTHOR
Pf | DEC 2014 | 19
Dear Santa,
Please bestow upon me,
job security, personal
development, training,
belief in present products,
a company share scheme, a
pension and a good
car scheme.
Yours,
pharma employee.
Sorry, my
relationship with you
is now in fourth place.
Get over it.
ANALYSIS BY

9. 20 | Pf | DEC 2014
Ian Munro,
Industry
Consultant
Anyone travelling
forward in time
from the UK
pharmaceutical
industry of 2009, to
the present day, would see a significantly
changed world. The NHS in England
looks very different compared with the
structures that existed five years ago.
Scotland has new SMC processes and
a peer-approval system for individual
treatment requests, while Wales and
Northern Ireland continue on their own
evolutionary paths. With these - and
other NHS reforms - come changes in
pharma, and the focus of its daily activity.
Among the most widespread and
noticeable changes are the focus on value,
and the move to cross-functional working.
As health technology assessment has further
established itself as the gatekeeper to the
NHS market, pharma’s focus has been
driven towards proving that its products
bring considerable health benefit for the
price charged, i.e. that the medicine is of
true value. Only then will it be accepted
and implemented. Manufacturers must now
align their operations into demonstrating
value, by producing credible evidence and
communicating it effectively to decision
makers. There lies one of the other great
changes in the last five years – we now need
to consider who the true power brokers are
within the NHS.
The people holding power over NHS
decisions on pharmaceuticals are certainly
fewer in number, and at higher levels of the
NHS, than before. Most have no clinical
involvement with patients, so the traditional
pharma model doesn’t fit the modern era.
As a result, many companies have made the
move, to a greater or lesser degree, towards
a key account management-type business
approach.
This wider appreciation of both clinical
and payer aspects of the business brings
together office departments and in-field
skills in new ways. Key account managers
(KAM) and key customer managers will
now often predominate in customer-facing
roles. They are effectively multi-skilled
professionals responsible, not just for
selling the clinical merits of their medicine
to prescribers (as in days of old), but
for the product’s place in the treatment
landscape, based on where, how and why
it delivers more to the NHS - clinically,
financially and for patients - than its
competitors. In-field CRM technology
arms are essentially KAMs with new levels
of information.
The modern UK pharmaceutical
industry is much leaner and more focused
than it was in 2009. The daily demand
for convincing value propositions will
continue to shape its activities and
structures, even beyond the breadth of
skills and cross-functional working we see
throughout the industry today.
Mark Struthers,
National Health
Economy Liaison
Manager,
Grünenthal
There are two areas
that have changed
and increased over the past five years; those
of technology and compliance.
In the area of technology, SMART devices
are being used more and more by all health
care professionals (HCPs), to read about
medicines, interact online - with sales
representatives and the pharmaceutical
industry - and as tools to communicate with
their patients. Therefore the investment
into digital communications has increased
significantly. Day-to-day, across the field,
selling with SMART devices has created new
The B g
Quest on
Ian Munro
?
M
ark Struthers
?
FEATURE
“Manufacturers must
now align their operations
into demonstrating
value, by producing
credible evidence and
communicating it effectively
to decision makers”
We take a reality check and ask real people,
real things about real life.
“How has day-to-day life in pharma

10. Pf | DEC 2014 | 21
skills to learn, together with more in-depth
and interactive ways to promote medicines.
Internally, using online meeting services
through LYNC, Skype and other platfroms
has been a great, time-efficient way for
local teams to communicate, with minimal
disruption to the working day. Although
nothing is better than a face-to-face
meeting, doing it online can cut down on
travel and nights away.
The speed and accessibility of Wi-Fi and
4G, provided on tablets, means that work
and admin can now be done in the field (or,
in my case, a well-known burger franchise)
in between calls. This is something that was
mooted to me back in 2002!
In the area of compliance - on a day-
to-day basis this is woven into everything
that is created, planned and delivered
within pharma, and at every level of the
organisation, to ensure the industry works to
the highest standards. For me this has meant
more investment in training and creation of
detailed SOPs and internal working groups,
to improve transparency. On a daily basis
this affects every individual within the
organisation, from planning and delivering a
local education meeting, to putting materials
through approval.
Lisa Syne,
National Sales
Manager, Aspen
Pharma UK
Day-to-day
life in pharma
is determined
primarily by
three key capabilities, meeting the needs
of patients, developing relationships with
customers, and the delivering of valued
medicine and services. During the past five
years, there have been significant shifts in all
these areas and, as a result, day-to-day life in
pharma has changed – and is continuing to
change – at an exponential rate.
The provision of healthcare has rightly
become much more patient-centric. For
pharma this means becoming much more
than a medicines-provider. Collaborations
on projects that facilitate better patient care,
such as enabling better treatment closer to
home, are increasingly central to our daily
lives.
Most of all, NHS reforms have brought
about dramatic changes in terms of who
our customers are, and how and when we
engage with them. Clearly, the optimisation
of resources is a priority for everyone, but
identifying and accessing budget-holders
can be difficult. Whereas decision-making
previously rested with one or two clearly
defined individuals, these responsibilities are
now much more dispersed.
Pharma has had to restructure its
traditional selling model to reflect these
changes. As a new entrant into the UK
market, Aspen Pharma UK has been able
to design its operating structure around the
needs of a changing NHS. Our small team
of KAMs are equipped with the expertise,
knowledge and relevant insights to engage
with customers across the whole health
economy.
The streamlined, agile team that we are
building is very different to the sales model
that was operating in the UK five years ago
and our day-to-day priorities are also quite
different. As experts in key specialty areas,
such as thrombosis, we focus on working
with customers – in whichever functions
they are located – ensuring a reliable supply
of high quality, affordable medicines and
services that meet patient needs.
Chris Frost, Sales
Director, AAH
Pharmaceuticals,
part of Celesio UK
There are three
dominating factors
that have changed
pharmaceutical
wholesaling over the past five years.
The first is the introduction of reduced
wholesaler, DTP and agency pharmaceutical
deals, with significant proliferation. In
order to secure deals with branded ethical
medicines manufacturers we now have
to be more ambidextrous, in terms of the
way we approach them, with upstream
wholesale margins squeezed. In turn, there
are reductions in pharmacy discounts
downstream as well.
This also initiated a complexity that
never used to exist, which is the second
dominating factor. A few years ago
pharmacies would be very loyal to one
wholesaler, and they would get the vast
majority of their business from them.
Now, pharmacies must deal with more
than one, with most dealing with two
full-line wholesalers, if not three. AAH
Pharmaceuticals, as an example, now
delivers to every single dispensing point in
the UK, rather than of half of them.
For that reason we have put significant
investment in our infrastructure, in
order to supply medicines twice daily to
pharmacies across the whole of the UK. It
also means we now have a broad spread of
customers, a big chunk of whom still order
the majority products from us, and others
who order only the lines that they have to,
because we have reduced wholesale, or have
exclusive contracts with manufacturers.
Thirdly, we have seen a significant
increase in the use of quotas to restrict
pharmacies from ordering large volumes of
stock, which they can therefore potentially
trade abroad to supplement their revenue.
It actually means that sometimes getting
all the stock can be quite difficult within
a short period of time, if they exceed their
quota. This can be extremely frustrating
from a pharmacy perspective, but is
something that manufacturers have to
impose on wholesaling orders, to prevent
exporting in excess.
For the foreseeable future, perhaps
the most encouraging evolutions are in
embracing technology, which will free up
pharmacists’ time to support the dispensing
process, manage prescription ordering and
help patients with long term condition
management and improve health outcomes.
The future challenge for wholesalers is to
differentiate themselves by improving the
added value services they provide, while
increasing revenue, margins and efficiencies
for pharmacists.
?
Lisa Syne
AUTHOR
Wi-Fi AHOY!
?
Chris Frost
“Collaborations on
projects that facilitate
better patient care are
increasingly central to
our daily practice”
“In order to secure deals
with branded ethical
medicines manufacturers
we now have to be
more ambidextrous”

11. 30 | Pf | DEC 2014
Head of Regional Accounts at Boehringer Ingelheim,
Nick Doe, discribes what talent means to him.
What is more important to success: ambition or talent?
Probably both; Ambition without talent is unlikely to lead to very
much, and talent without ambition in one role for too long can lead
to stagnation.
How does Boehringer Ingelheim help develop employees to
achieve their full potential?
Employees are encouraged and supported to develop, grow and
discover new talents and strengths. We use strengths-based working
so employees can harness and develop their strengths i.e. things
they are really good at and enjoy doing. If people are energised and
focussed on the positives it helps them achieve their full potential.
How are strengths identified and is this something that
employees have to highlight individually?
An online strengths identification tool is available to all employees
to help them identify their strengths along with team development
toolkits, which help managers incorporate their team’s strengths
into day to day working. In addition employees are encouraged to
identify their own strengths and the strengths of others through
self-reflection, day to day observation and feedback. The aim is to
integrate a person’s strengths into existing performance review and
talent discussions.
If someone is naturally good at something are they then
developed further?
Yes, it’s much more than just working with a person’s existing
strengths. Personal development and growth is very important to us.
Boehringer Ingelheim Ltd believes that in order for development to
be most impactful for both the organisation and our people, a variety
of approaches should be used. Self-development tool kits are provided
and employees are encouraged to get feedback from their manager and
peers in order to develop themselves further.
What about training, is this something that you invest heavily in?
We offer a wide range of learning and development solutions to support
people with their personal development. Training is offered, both
internally and externally, but in addition mentoring and coaching
programmes also prove invaluable. Employees often gravitate towards
an individual they both admire and click with; these colleagues can
become mentors, and offer support and guidance throughout a person’s
career development.
If an individual is interested in doing something different, is
this something that they are encouraged to investigate further?
Employees have regular, development and career discussions with their
manager, which provide the perfect opportunity to explore future
career aspirations and identify development opportunities. Employees
are frequently offered secondments or projects in different departments
in order to stretch them and help them achieve personal growth. These
can potentially lead to a new role or change in career direction and also
help increase the scope of their current role if they wish.
All these things help our people to be energised,
motivated and thriving in their roles, ultimately
driving their success and the organisation’s
success in a fast moving and highly competitive
environment.
Formal chair
Former Chair of the National Institute of Health & Clinical Excellence (NICE), Professor Sir Michael Rawlins, has
been appointed Chair of the Medicines and Healthcare Products Regulatory Agency.
Book lover
Smith and Nephew has named Chief Executive Officer of publishing and information company, Reed Elsevier,
Erik Engstrom, as a new board member. Mr Engstrom’s former employers include General Atlantic Partners,
Random House and Bantam Doubleday Dell Publishing.
All together
NHS England has announced plans to create a single integrated team for each of the current regions, and will be
appointing several Directors of Commissioning Operations. Each will have responsibility for their sub-regional patch.
Talent development
Ooops! When Nick recently appeared, with some excellent advice,
in the ‘High Flyer’ section of these pages, we accidently included a
quote – “You can’t train or develop talent – you either have it or you
don’t” - that wasn’t from him and doesn’t represent his views or the
company’s. Sorry about that, Nick.

12. Pf | MARCH 2014 | 31
Presentations are a standard element of
most interview processes. Interviewees often
assume that they will be able to tackle a
topic for a presentation with ease. There
are, however, a few techniques that can help
make you stand out and secure the role you
have applied for. Presentation content will
be a key focus for the interviewing panel,
but equally as important is the structure,
layout and approach that you take.
Companies will mark candidates on all of
these factors and it should not be assumed
that your existing method of presenting will
be what every client looks for.
Topics and types of presentation can
vary widely between companies, or even
different managers within an organisation.
Most recruiting managers will be looking
for a presentation which answers the
question, is laid out in an ordered format
and has a logical flow. Slide content needs
to be succinct with limited bullet points,
which allow you to expand further and talk
around each particular topic.
You should set a clear agenda of what
you are there to discuss and how you are
going to go about it. At the end of the
presentation, a summary of the salient
points should be covered, emphasising
what you want your audience to remember
about the presentation and about you. This
is a good opportunity to reiterate your
skill set and competency in explaining
why you should be the successful applicant
for a role. As a final pointer; as with most
presentations that you will do in your daily
role, preparation and practice is vital to
success.
Andy Anderson
Recruitment Director, Evolve Selection
| |0844 357 7332 / 0113 871 0001
www.evolveselection.co.uk / recruitment@evolveselection.co.uk
Name: Reg Nathan
Job: NHS Business Manager
Time in current role: Two years
Time in pharma: 30 years
First job: GP representative for Norgine Ltd
Success is....
Being happy with what I do and who I am.
What sets you apart in the work place? It
isn’t any one thing, but I believe that being
fair, honest and working hard are values that
have helped me in my career.
What techniques have you used to ‘climb
the ladder’?
Being able to recognise an opportunity that
presents itself, making the most of it and
being able to adapt to the new challenge.
What is more important to success:
ambition or talent?
Having both is important to achieve what
you want. Ambition without talent will limit
your choices, make you feel frustrated and
lead to a lack of progression.
What drives you on?
Being able to work in an environment that
encourages innovation, entrepreneurship
and delivers the best solutions to improve
people’s lives.
What would you consider the major
milestones of your professional life?
Moving from Yorkshire to Scotland for an
HDM role, and taking on the management
role with RB.
What is your proudest moment so far?
In work, getting the Regional Business
Manager position and being part of the best
performing NHS team at RB.
What advice would you offer an
ambitious colleague?
Know what you are trying to achieve, take
advice from those around you and deliver
results.
Where would you like to be five years
from now in terms of professional
progression?
I want to be the best I can be in my current
job. I still have a lot to learn and success will
bring the next opportunity.
How important is professional
development to getting ahead in a work
environment?
Very important. It is up to you to have a plan
for developing your skills; take on projects
that introduce you to the new experiences
and ideas that will lead you to your next role.
Have you got/had a mentor?
Not formally, I have always tried to learn
from those I have worked for and with, and
incorporate learnings to fit my style and
personality.
Why is working hard and achieving
success important to you?
Both of these elements go towards happiness
in work and life.