Pf May 2016

APRIL 2016
Hard cell
Could cancer be sent packing
by a brave new therapy?
Going underground
Let’s discuss the virtues of
Transformers
rights is underway
MSD HERO BAGS
Pf AWARDS
HAT-TRICK

@NewPfMag @Pharmajobs.co.uk
Editor John Pinching
Assistant Editor
Designer
Sales & Marketing Director
Finance Manager
Pf Awards
Publisher
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Let’s cook
M
*A facetious ‘example’, which emphasises that I have
never watched the program in question.
Pf | APRIL 2016 | 1
APRIL 2016
Hard cell
Going underground
Transformers
rights is underway
MSD HERO BAGS
Pf AWARDS
HAT-TRICK
17/03/2016
10:04
APRIL 2016
Hard cell
Going underground
Transformers
rights is underway
MSD HERO BAGS
Pf AWARDS
HAT-TRICK
17/03/2016
10:04
APRIL 2016
Hard cell
Going underground
Transformers
rights is underway
MSD HERO BAGS
Pf AWARDS
HAT-TRICK
17/03/2016 10:04

3 Flash news
8 Trophy cabinet
10 Cancer cancelled?
12 Bo selector
14 Scritti politti
16 Good neighbours
18 God bless
20 Mindfulness matters
23 Talk is cheap
24 Pill amnesty
26 Time travel
2 | Pf | APRIL 2016

Scots denied
skin cancer drug
Pf | 2016 | 3
FOR MORE INDUSTRY NEWS GO TO
PHARMAFIELD.CO.UK
FOX NEWS

The National Institute for Health
and Clinical Excellence (NICE) has
preliminally rejected Janssen’s
leukaemia therapy Imbruvica.
Draft guidelines, published by
NICE, rejected its use on the grounds
of cost. This could mean that NHS
patients in England and Wales,
lymphocytic leukaemia (CLL), may
be denied access to the drug, which
has been hailed as a potential future
blockbuster by industry experts.
48 other countries - including 27
European countries - have opted to
fund or reimburse the medicine.
NICE said that uncertainties in
Janssen’s submission leave it in
doubt over whether Imbruvica
of NHS resources in this setting.
Imbruvica is currently available
through the Cancer Drugs Fund in
England, for use in adult patients with
relapsed or refractory CLL.
to the Department of Health at a
discounted rate to its list price of
£55,954.50 (excluding VAT), for a
year’s course.
Janssen said it was “extremely
disappointed” with NICE’s stance.
Mark Hicken, Janssen UK’s
managing director, added that the
decision was “yet another example
of how the current NICE appraisal
responding to the needs of cancer
patients, and the healthcare
professionals who treat them”.
recommendation.
NICE no to Janssen
leukaemia drug
vaccine has received a positive opinion
from the European Medicines Agency’s
granted for a 2-dose schedule in
adolescent boys and girls aged 9 - 14
years of age.
9-valent Vaccine (Recombinant,
adsorbed) is indicated for active
immunisation of individuals from the
age of 9 years, against cervical, vulvar,
vaginal and anal cancers, and genital
types.
The vaccine was originally
approved in the EU in June 2015,
with a three-dose schedule for all
age groups. The positive opinion was
adopted on 26 February 2016.
The EU application is based on the
results of a clinical trial performed in
around 1200 girls and boys, aged 9 to
14 years old, and 300 young women
aged 16 to 26 years old. This was the
vaccine was demonstrated.
2-dose schedule will now be reviewed
by the European Commission, which
has the authority to approve medicines
for the EU.
School, said: “Approval is great news,
both for young women and the NHS,
and will increase the number of young
women who are protected against a
HPV jab gets go ahead
4 | Pf | APRIL 2016
Department of Health @DHgovuk
We’re building a higher quality
NHS for patients with dementia -
safer care throughout the week
#actionondementia
The NHA Party @NHAparty
Join our mass-whistleblowing
tomorrow evening at 7pm
#PublicDuty #JuniorDoctorsStrike
John Pentony @StockGuruDotCom
Chembio to Collaborate With Bio-
Manguinhos/Fiocruz to Develop
Point-of-Care Zika Diagnostic
Tests for Brazil
Harvey & Hugo Ltd
@harveyandhugo
Pharma giant brings 100
new #jobs and fresh start to
Sarah Misandrist @sazza_jay
Cost of meningitis vaccine for
all children: £1.3bn Cost of nuke
programme that will never be
used: £100bn.
Jeremy Hunt @Jeremy_Hunt
Thank you @KESWNews for
adopting @NyumbaniUK as your
chosen charity - fundraising for
orphaned children living with HIV
& AIDS in Kenya
Pﬁzer Inc. @pﬁzer
we want to honor those involved in
#clinicaltrials to further research.
#raredisease
GSK @GSK
Congrats @viveshogeschool
participants - the world record for
largest chemistry lesson has been
set #GrootsteChemieles
Bernie Sanders @BernieSanders
I do not receive millions of dollars
from Big Pharma and I do not
give speeches for hundreds
of thousands of dollars to Wall
Street.

General News Personnel News NHS News Drugs News
Psoriasis therapy gets EU OK
Lilly’s psoriasis therapy ixekizumab has
been recommended for EU approval
by Europe’s Committee for Medicinal
Products for Human Use (CHMP).
A positive opinion for ixekizumab
has been issued by the European
Medicines Agency committee for
the treatment of moderate-to-severe
plaque psoriasis in adults who are
candidates for systemic therapy.
The recommendation was based
programme in moderate-to-severe
plaque psoriasis.
ixekizumab.
authorisation of the drug is expected to
Andrew Hotchkiss, president of Lilly’s
European and Canadian operations,
said: “This CHMP positive opinion is
for their patients with moderate-to-
severe plaque psoriasis.”
Novo Nordisk has reported a
breakthrough during the testing of
diabetes.
Trial results suggest that its drug
Tresiba (insulin degludec) carries
a reduced risk of hypoglycaemia
(insulin glargine).
Tresiba matched Lantus for blood
sugar reduction and demonstrated an
patient years for insulin glargine.
Tresiba also reduced the incidences
versus 429.
Executive vice president and chief
Mads Krogsgaard Thomsen, said:
“We are very excited about these
trial results, which document that
of hypoglycaemia, compared to insulin
with the aim of updating the label for
Tresiba.”
received a positive opinion for EU
approval as a treatment for advanced
lung cancer.
The European Medicines Agency’s
Committee for Medicinal Products for
for the treatment of patients with
advanced squamous cell carcinoma
of the lung. The drug is recommended
for those patients whose disease has
progressed on or after treatment with
platinum-based chemotherapy.
Results from the LUX-Lung 8 trial
showed that the drug can delay the
progression of lung cancer, and
disease. The head-to-head trial also
found that the drug improved quality
of life and helped to control cancer
symptoms.
The LUX-Lung programme, which
represents the largest collection of
tyrosine kinase inhibitor, includes the
LUX-Lung 8 trial.
Dr Mehdi Shahidi, medical head of
solid tumour oncology at Boehringer
represent the potential availability
squamous cell lung cancer, it also
agent.”
Giotrif
moves closer
to EU approval
Novo Nordisk in diabetes
drug breakthrough
Pf | APRIL 2016 | 5

No one is to face charges over the Mid-
Junior
doctors stage
third walkout
6 | Pf | APRIL 2016
No blame established for

General News Personnel News NHS News Drugs News
Pf | APRIL 2016 | 7
Zika virus misery
continues with neuro risk
New research has shown that the
Zika virus ‘might cause’ a severe
neurological disorder.
The study involved using the
blood samples of 42 patients who
had previously been infected by
the mosquito-borne Zika virus. The
evidence showed that the virus could
cause Guillain-Barré syndrome, a
neuro disorder that causes muscle
weakness and, potentially, breathing
problems resulting in the patient
needing admission to intensive care.
The Lancet authors reported that
subjects developed neurological
problems associated with the
syndrome around six days after
infection with the Zika virus.
Zika has already been declared
a public health emergency of
international concern by the World
Health Organisation, because of its
suspected links to microcephaly,
a condition that leads to under-
developed brains in babies.
Guillain-Barré syndrome is a rare
response to infection, where the
immune system attacks peripheral
nerves. Scientists predict that there
could be one case of Guillain-Barré
among every 4000 people falling ill
with Zika.
Professor Hugh Willison, from
Glasgow University, urged caution as
he told BBC News: “On an individual
level, we shouldn’t be frightening
people into thinking that if they get
Zika infection they’ll automatically
get Guillain-Barré - because the risk
is actually rather low. But if a million
people get infected with Zika, that’s
hundreds of unexpected cases of
Guillain-Barré.”
Figures from the WHO show that
Venezuela, Surinam, El Salvador,
Colombia and Brazil have all recently
reported increased numbers of people
with the syndrome.
FOR MORE INDUSTRY NEWS GO TO
PHARMAFIELD.CO.UK
FOX NEWS
Ebola nurse back in hospital
for third time
already battled Ebola twice, has been
back in hospital for a third time.
the virus in December 2014, while
working with Ebola victims in Sierra
and spent almost a month in isolation
at the Royal Free hospital in north
treatment with a survivor’s plasma and
an experimental antiviral drug.
She again fell ill with Ebola in
October 2015, and almost died
from meningitis caused by the virus,
an event described at the time as
“unprecedented”. She once again
recovered and returned home to
South Lanarkshire.
It has now emerged that she was
admitted to the infectious diseases
unit at Glasgow’s
Queen Elizabeth
University
hospital to be
treated again.
has now been
discharged and
is recovering at home.
There is currently no approved
vaccine or treatment for Ebola. Last
month, however, the Gavi alliance for
vaccines and immunisation signed
to buy an Ebola vaccine currently
under development. A clinical trial
in Guinea, involving 4000 people
who had been in close contact with
an Ebola case, has shown that the
after ten days.
Queue for
B jab in NI
Private hospitals in Northern Ireland
have reported an increase in the
number of inquiries about the
parents, whose children are not
eligible for the vaccine under the NHS.
are on a waiting list for the vaccine
after it ran out of supplies recently.
so far been signed by 700,000 people
and counting, making it the biggest
online petition in Parliamentary history.
Lee Booth started the petition last
September after his baby daughter
was denied the vaccine on the NHS
because she was deemed to be too
signatures, until awareness was
raised further, when the mother of
two-year-old Faye Burdett shared a
heartbreaking photo of her daughter
dying from meningitis in hospital. Faye
days.
Under national NHS guidelines,
only available to babies as part of the
national immunisation programme.

T
his year’s Pf Awards proved
one of the most memorable
in the Awards’ illustrious
history. For 16 years Melanie
Hamer has strived tirelessly,
passionately and often sleeplessly to
champion the skill and talent of pharma’s
intrepid sales force.
The company she runs with husband,
Karl - Events 4 Healthcare - has always
delivered the nerve-jangling assessment
process and, constantly-evolving awards,
since their conception, at the turn of the
century. This year, however, represented
a new milestone, as the couple became
the proud owners of Pf Magazine.
Indeed, they will be using all their zeal and
experience to guide it into an exciting new
chapter; making it the ultimate publication
With that in mind, it was uplifting to
see the great and the good of pharma
convene, for yet another unforgettable
evening of proud achievements and,
of course, celebration. After a year in
the deadly serious cauldron of pharma
recognition, but also the opportunity to
The pre-presentation excitement,
cocktail of industry voices from across the
spectrum - those voices spoke of elation
and fear, for the time of reckoning was
upon us.
Glory hunters
guests up for the trophy hunt. Above
the cacophony, the unmistakably
ebullient, and famously disembodied,
tones of Alan Dedicoat soared;
to proceedings. After years of
dedicated service to the Pf Awards, it’s
fair to say that he is rapidly becoming
‘voice of the pills’, never mind ‘the
balls’.
of entertainment. James Acaster is one
of these contemporary young comics
with a carefully developed ‘careless
appearance’, involving hopelessly
adolescent observations included
the confusion brought on by cheese
graters, the terrible standard of amateur
achievement - Calpol. Amen to that.
As the laughs subsided - replaced by
barely-veiled trepidation - the evening’s
presenter was introduced, and TV’s
Gethin Jones, no less, took centre
stage. And it was a sound choice,
judging by the chorus of - admittedly
female - approval. The ‘ordinary boy
from the valleys’, however, soon won
over the entire crowd - regardless of
gender - with some riotous banter and
Welsh charm.
For the sixteenth consecutive year the Pf Awards
salute industry’s dazzling array of sales talent.
Pf Awards make
history as Mykie
lands trio of titles

Gethin also appeared to understand
his vital role as key master to the
dreams of top candidates - his
generous enthusiasm added a further
note of gravitas, as he made his way
through the glittering roll of honour.
One of the most compelling sights
at the Pf Awards is witnessing the
reactions of our winners. The full range
of human emotions are laid out -
disbelief, joy, pride, confusion and, yes,
even the odd tear.
Three is the magic number
There was also a new chapter written
in the Pf Awards history books as
MSD’s Mykie Leong-Chadwick stole
the show, helping himself to three
pieces of crystal. He will have to get a
considerable mantelpiece extension
for his richly deserved Commercial
Innovation, Outstanding Performer and
Account Manager titles.
In a state of stunned disbelief Mykie’s
life had already changed forever. “I can’t
believe this - I’m speechless,” he said.
“I’ve only got two days left in women’s
In many ways he epitomised modern
pharma - passionate, humble and
always moving.
In that respect, it was also interesting
to note that, as the awards concluded,
a ten-deep throng of pharma
womenfolk had surrounded Gethin, in a
post-awards scrum. Posturing, pouting,
posing and proposing - it was a frenzy
fear, he may never escape.
Under normal circumstances
this author would be consumed by
bitterness and insecurity, but you
couldn’t help admiring the way he
made every star struck, starry-eyed,
knee-knocking seductress leave with
the impression that they might - just
might - be the next Mrs Jones.
We can be heroes
the reason we keep coming back - after
all, we know that this industry has some
of the best people in the country, when
it comes to getting treatments through
the door, articulating medicinal wizardry
and, above all, transforming the lives of
patients on a daily basis.
The pharma sales force are the
unsung heroes of healthcare - end
of. With this considered, if we make
our winners - and, indeed, everyone
in attendance - feel like they’ve
accomplished their ongoing mission for
one evening, it’s been worth it.
For more about Pf Awards 2016 go to
pfawards.co.uk
ROLL OF HONOUR
Primary Care Specialist Award Kristine Stanhope-Campbell from
Bayer PLC
Clinical Nursing Award Dominique Muir from Quintiles Ltd
George Psaroudakis from Bayer PLC
Sales Team Award Myles Hall and Sam Strong from Forte UK
Account Initiative Project Award Luci Lakeland from Bayer PLC
Emerging Talent Award Shakti Chauhan from Johnson and Johnson
Diabetes Care Companies
Secondary Care Specialist Award Oliver Hardman from LEO Pharma
Remote e-Representative Award
Account Manager Award Mykie Leong-Chadwick from MSD
Learning and Development Initiative Award Raheel Mirza from
Account Management Team Award Roger Lord and Trevor Baguley
from Bayer PLC and Michael Challice from MSD
Team Manager Award Elizabeth Stacey from Grünenthal
NHS Recognition Award Cate Oliver and Melissa O’Reilly from Apodi Ltd
Commercial Innovation Award Mykie Leong-Chadwick from MSD
Outstanding Performer Award Mykie Leong-Chadwick from MSD
AUTHOR: JOHN PINCHING

E
xciting news from the
world of cancer therapy
research emerged recently
as scientists announced
the news that - after
experimental clinical trials using
T-cell therapy on patients with a
certain type of blood cancer - over
half of the terminally ill patients had
entered complete remission. These
“unprecedented results” got the world
buzzing - could it be the revolutionary
cancer cure that has eluded scientists
for years? Yes - well possibly - but
there’s the usual raft of cautionary
stipulations.
The results of these trials,
announced at the annual meeting
for the American Association for the
Advancement for Science, showed
that in one study, the symptoms
of 94% of participants with acute
lymphoblastic leukaemia completely
disappeared. Patients with other blood
cancers experienced response rates
over 80%. Meanwhile, more than half
experienced complete remission.
These are undoubtedly mind-boggling
numbers.
According to Dr Alan Worsley,
Cancer Research UK, the results
reveal a treatment worth pursuing, but
there is much to be done: “It’s a really
promising treatment for blood cancers,
where normal treatment has failed,”
he said. “These are great results for
people with months to live. For those
few patients it was great - but we have
a long way to go.”
The opportunity to trial a living
therapy gave patients a chance for a
last resort treatment, when all others
had failed. Most of the patients had
just months to live. Among those, the
T-cell trials showed ‘extraordinary
results’.
Seek and destroy
The immune system is a massive and
complex army, constantly patrolling
These soldiers are tasked with many
strongest of them are T-cells.
When ‘helper’ T-cells detect a
damaged cell, they respond by
sending signals to the other immune
system troops for help. Once the
a threat, the bounty hunter T-cells take
out the enemy cells by administering a
lethal injection.
Cancer cells are masters of disguise,
however, and have developed many
tricks for staying hidden from the
T-cells, and their meddling receptors.
The other problem is that T-cells are
between cancer cells and healthy cells,
allowing cancers can grow undetected.
The answer is to modify T-cells by
redesigning their system for targeting
10 | Pf | APRIL 2016
“The opportunity to trial a
living therapy gave patients
a chance for a last resort
treatment, when all others
had failed”
Is this the
cure for
cancer?
Extraordinary T-cell therapy results have
emerged. Is this really the cure for cancer
we’ve been praying for?

damaged cells, so that they become
cancer-seeking missiles, enabling
them to distinguish cancer cells from
healthy cells. This upgrade is inspired
cell that has its own lethal weapon -
antibodies. They will have Holmes-like
insight, and can see right through any
disguise a cancer cell can come up
with. They then stick to the cancer cell,
but can’t kill it.
take the detective skills of B-cells, and
the killing power of T-cells, and create
a deadly hybrid. These upgraded
Chimaeric Antigen Receptor T-cells
- or CAR T-cells - and according to
Dr Worsley, they could be the start
against cancer.
“There are a lot of options, and
scientists are playing with these. We
therapy safe, and something that can
also work on solid cancers,” he said. “If
we can get it to work in other cancers
too, it’s very exciting.”
Risky business
This type of therapy is considered
a last resort because the
‘reprogramming’ of the immune system
These include:
Cytokine-Release Syndrome (CRS)
target cells they quickly activate and
release cytokines. These chemical
messengers support the work of the
T-cells, but they may cause deadly
B-Cell aplasia - CAR T-cells kill
cancerous B-cells, but they also kill
normal B-cells. Low numbers or the
absence of any B-cells leads to being
forever immuno-compromised.
Tumor Lysis Syndrome (TLS) - as
dying cells breakdown, as a result
of the therapy, it can cause severe
complications, most commonly
after the treatment of lymphomas
and leukemias. TLS is potentially
fatal because the changes in blood
electrolytes and metabolites, caused
by the breakdown of the dying cells,
can lead to dangerous complications,
including acute kidney failure, seizures,
cardiac arrhythmias and death.
Two of the patients taking part in
the most recent CAR T-cell trials
including neurotoxicity, hypotension
Another question for researchers
now is whether this therapy works
on a long term basis.
What’s next?
The trials carried out so far have
focused on targeting certain liquid
(blood) cancers that develop from
B-cells, including acute lymphoblastic
leukaemia, chronic lymphocytic
leukaemia and non-Hodgkin
lymphoma.
“These liquid B-cell cancers are the
‘low-hanging fruit’ of cancers,” said Dr
Worsley. “The catch is that the ‘marker’
that the T-cells target and destroy is
found in all B-cells, both cancerous
and non-cancerous. B-cells all carry a
unique marker, and the mechanism of
T-cell therapy means that they’ll go in
wiping out all B-cells, good and bad.”
The next big question is whether the
solid tumours, such as breast cancer
and liver cancer, without also taking
out the healthy cells. “You can live
without B-cells, though you’ll be
forever immuno-compromised,”
warned Dr Worsley. “But you can’t
survive if treatment is wiping out liver
cells.”
Research at University College
London and Great Ormond Street
Hospital is looking into creating a ‘kill
switch’ to get around the problem of
In the US, the University of
Pennsylvania recently unveiled a new
$27 million Novartis-Penn Center for
Advanced Cellular Therapeutics. The
facility will be devoted to developing
CAR T-cell therapy treatments for
cancer.
Eyes on the prize
Researchers acknowledge that there
is still a way to go, and the long-term
outcomes of those people involved
in the studies, so far, are yet to be
seen. The cells in this living therapy
have the potential, however, to live
in the body for a lifetime. These
‘memory cells’ have been tracked
in another trial, for two to 14 years,
after they had been introduced into
cancer patients for whom bone
marrow transplants had failed to
work.
have the potential to act as a cancer
vaccine, remembering cancer from
a decade ago, and immediately
attacking and killing it if it reappears.
The potential of the therapy is
huge, but the forecast cost is too.
“Genetic re-engineering is specialist
and labour-intensive, so the
challenge is how it can work across
the NHS,” said Dr Worsley. “One
that can be stored in a bank.”
“It’s absolutely a type of treatment
worth pursuing,” he concluded.
It’s still early days - and
engineering is more safe and
research is going to take time,
Progress is encouraging, however,
and that will give millions reasons for
optimism.
“The answer is to modify
T-cells by redesigning
their system for targeting
damaged cells, so that they
become cancer-seeking
missiles”
Pf | APRIL 2016 | 11
is to take the detective skills
of B-cells, and the killing
power of T-cells, and create
a deadly hybrid”
AUTHOR: AMY SCHOFIELD

M
arket access remains one
of the pharmaceutical
industry’s greatest
challenges, as it strives to
ensure that the value of
innovative products is clearly explained
to relevant healthcare stakeholders.
Tom Sunderland, Director of Market
Access at pharma giant, Boehringer
Ingelheim, knows all about the
challenges, having joined the company
back in early 2008. He has held a
number of roles - since starting as a
junior health economist - and quickly
realised that BI did things a little
“Traditionally, pharma outsourced
to get the expertise you need to
go through a health technology
assessment (HTA), with the likes of
the National Institute for Health and
Care Excellence, and the Scottish
Medicines Consortium,” he told Pf. “BI
took the view that keeping everything
in-house would lead to a better quality
of submission”.
It also made economic sense, given
the number of HTAs it was preparing.
“We had a massive pipeline,” he added.
means that BI has high levels of
interest in the health economics world.
“Many other companies still outsource,
so what we have is fairly unique,
especially in terms of the opportunities
we provide in personal development,”
Sunderland said, adding that, for those
Olympics, and NICE is the best in the
world”.
The importance of NICE globally
is huge, he said, noting that many
countries - particularly in eastern
Europe and Asia - have not even
bothered setting up their own agencies.
“They wait until they hear what NICE
says, as there is no point replicating it -
you won’t get a more robust analysis”.
BI has had a good run with NICE,
and its own formidable approach to
HTAs has resulted in several successful
appraisals. When it comes to market
access, however, this is only the start
of a sometimes tortuous process.
Sunderland noted that “we do
these very in-depth, full-on HTAs for
NICE, the SMC and Ireland’s NCPE,
and treatments get recommended in
guidance”.
“That’s great, we are doing
delighted,” he says, but then the
dreaded barriers come up.
Sunderland can speak about this
with authority, as he did a year in the
slammed in my face” - as he put it. He
approval, and access to a medicine,
does not really translate to a local level.
The NHS Constitution says funding
must be available to those treatments
backed by NICE. Sunderland states
that a drug “might make it onto
formulary, so that a box is ticked, but it
does not mean there is a protocol, and
it does not mean the patient will get
access”.
12 | Pf | APRIL 2016
“BI took the view that
keeping everything in-house
would lead to a better quality
of submission”
Tom Sunderland
Boehringer Ingelheim’s Tom Sunderland talks to Pf about the company’s in house
sector work placements.
Home is where the heart is

Companies then have to deal
ago?
Pf
Go to boehringer-ingelheim.co.uk
Pf | APRIL 2016 | 13
AUTHOR: KEVIN GROGAN

O
f the £30bn funding gap
facing the NHS by 2020, it
is expected that £22billion
will be found from
spend, but has also - more interestingly
- brought a whole new meaning to
synonym for new - as in a new method,
product or idea - might wish to look
at current policies focussed on how
expected to contribute towards that
On the one hand, there is a push for
treatments while, on the other, a need
- a more appealing word, perhaps,
meanings, and the policies surrounding
position on both?
all been focused on these goals too, but
not surprising - nor unwelcome - that
this real-world experience forms the
patient outcomes, through harnessing
as its main focus, and is doing this
assessment, and adoption of new
an ambitious system for new drug
domestic life sciences industry, and this
recommendations, and though there
is much optimism for their contents,
dubious buy-in from the NHS may
recommendations has become an
the law behind a policy can help, and
the position where it has a good chance
unpalatable to many, and much to Lord
albeit with many of the original elements
progressing through parliament, owing
14 | Pf | APRIL 2016
career in biomedical
surprising, nor unwelcome,
that this experience forms
the basis for much of his
policy”
The NHS
paper trail
sense of the tornado of past and present
legislation currently blowing through

I
f rumours are to be believed, the
beleaguered doctors and nurses of
Great Britain will soon gather their
meagre possessions, and make a
brave pilgrimage across the equator,
into the hallowed Jeremy Hunt-free
zone of the Southern Hemisphere.
Here they will - apparently - discover
tranquillity, reasonable hours, group
hugs and a climate only previously
witnessed while watching Home and
Away. As if to predict the current
away on the slow boat to a better life,
out the reality behind the Australian
dream.
When I was younger I did some work
experience at St Bartholomew’s
hospital’s physiotherapy department,
and very quickly discovered that it
was exactly what I wanted to do. It
was practical, it was physical and
you could see that you were making
patients up and out of bed, helping to
get them back home and encouraging
them to do the things they enjoyed.
I grew up with both parents as doctors
and - although I didn’t want to be a
doctor - seeing the passion and love
they had for what they did, certainly
Wanting to help people is part of my
nature, and that has probably been
passed down.
I like being with people, and that’s really
important with physio, because you get
to know people very well. You work with
them over a very long period of time
- helping their rehabilitation, and also
getting to know them as a person. You
understand what makes them tick and
discover what’s important to them.
I love that about physiotherapy - the
long-term relationship building and the
trust you gain.
I did my Bachelor of Sciences (Hons)
in Physiotherapy at Southampton
University.
No, I think it’s probably the worst.
The university has a good reputation
in medicine and - in particular -
physiotherapy. As part of the course we
and that was a very important part of
the learning curve.
I did my junior rotations at Poole
Hospital for 18 months, and it was a
lovely place to start my career. It really
reinforced my decision to go down this
path, and was a great introduction to
that I left for Australia.
I met an Australian - Rob - who is now
my husband, and I moved to the other
side of the world with him, to start a
new life together. I knew I could be a
physio there - all I had to do was sit
another exam, in addition to my existing
reasons for emigrating, I realised it was
a great move career-wise, as physio is
a well-renowned discipline in Australia,
and probably more highly-respected
than it is in the UK.
Physio is a relatively new profession, so
Australia is a younger country. It has
been much more integral to their
healthcare system from the outset,
rather than being a very new thing
introduced to a very old system, like in
the NHS.
I’m practicing in musculoskeletal physio,
and that involves assessing people’s
complaints, whether it be back, neck,
shoulder or knee pain. It could be in a
post-surgical context, or more about
Vegemite sandwiches with a healthcare professional who
swapped the NHS for Aussie rules.
16 | Pf | APRIL 2016
WITH CORENA CALTABIANO
JOHNPIN
C H I NG’S
“Australians are more likely
to visit a private hospital
Britain, people access the
and it wouldn’t occur to
them not to”

delaying or preventing the need for
surgery. It’s then about managing or
reducing their pain, and rehabilitating
them back to the activities they are used
to. This might involve improving the range
of movement in a joint, strengthening
muscles or improving balance and co-
ordination.
Do you get very ‘hands-on’?
Physio is a very hands-on job - we
use our hands to assess muscle tone,
establish how much joints move, measure
strength and carry out treatment. Physio
has developed a lot recently, and there
is much more of an exercise component
to it - the responsibility for recovery is
is all done respectfully, but people have
a good appreciation of what has to be
done in order to achieve results.
What are the most striking
The public health systems are fairly
be the extent to which the NHS is in
demand. The culture in Australia is
have health insurance, and Australians
are more likely to visit a private physio,
call. In Britain, people would access the
occur to them not to. That cultural shift
took me a long time to get used to. After
system, I did make the move into the
private sector a couple of years ago.
Because of my upbringing, it was a really
I gave to be determined by a business
model. There was a lot of debate in my
mind, but, ultimately, the chance to gain
a range of new skills, was an opportunity
I couldn’t ignore. This included parts of
physio I never would have experienced in
the public healthcare system, like acute
sports injuries.
It’s interesting that you had a moral
It’s always been in my mind that I would
one day return to the public health
system, but, when I do, I will have even
more skills to take back with me. In the
musculoskeletal area you have to see
everything you possibly can, if you want
to progress to the specialist level.
I think people want services quickly - they
are very aware that in the public health
system things can take a long time, and
patients might be limited in how much
service they can receive. Unfortunately,
one of the major problems in Australia
is the abuse of A&E, because some
people would rather go there for a regular
complaint, as they don’t have to pay.
I think it is imperative to have a good
public health service. When society
becomes too private-based, it is
health problems, especially if they can’t
you are faced with a healthcare class
system.
Australia is a very multi-cultural country,
with many people that have emigrated
like me. My husband’s family are
Australian, and that has also enabled me
family in Brisbane and a family in Britain -
to me, they both represent ‘home’.
I’ve spoken to people in Australia, who
moved 60 years ago, knowing they
would never see their families ever
again. Among them was my husband’s
grandfather, who came to Australia from
Italy. It was a much braver decision then
than it is now - I knew that if something
went wrong, I could come straight back.
The advances in modern technology, like
video conferencing, have enabled me
to see, and talk to people frequently. It
doesn’t feel like you’re on the other side
of the world.
Bye John!
“I’ve spoken to people in
Australia, who moved 60
years ago, knowing they
would never see their
families ever again. It was a
much braver decision than
it is now”

W
e’re heading into the
Spring season in
Northern California,
and it has been raining
before Christmas - there had been
six years of drought, so most people
up, the hills are green instead of
There have been many jokes about us
bringing our British weather with us,
I was driving to work this morning,
with rain, and I was only able to see a
Hayward or any boats in the
Bay - it was almost like being
throwing away the wellies,
before we moved, was a tad
normal daily pattern now,
both from a work and a personal
we aren’t out and about in the week,
and rationing ourselves to one House
of Cards
temptation to binge is just about being
My mother has been visiting from
sunniest two weeks we have had for a
us, and I’m missing her now she has
new role at work, the more I feel that
getting my head around the
payer environment - I am
starting to understand a little
more, but have also realised
that many other people
really understand the system
you are a ‘newbie’, but I am
18 | Pf | APRIL 2016
“There have been jokes
about us bringing our
British weather with us,
and that we should feel
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female - to be opposite to one’s
biological sex, is currently perceived as
being a highly specialised area, and it
is a fact that there is a lack of cultural
competency and understanding
around the subject among most health
professionals. This has to change.
Because GPs often lack even the
basic knowledge that they need, they
are under-skilled when dealing with
this group, and nervous of making a
mistake. Protocol is unclear and, as
such, GPs don’t know where to refer,
never mind how to treat patients.
Throw in a little personal prejudice and
the resulting experience on the part of
the patient can be devastating.
Patients visiting their GP on a
gender-related premise are often
referred to mental health services.
Gender variance is not a mental
illness, but can be associated
with psychological and psychiatric
morbidities, mostly due to the stress
of the condition, and the personal and
societal reactions to it.
When patients are seen by mental
health experts, it is often the case that
they are just as under-skilled, or ill-
prepared to help, as some GPs. When,
grail’ of specialist treatment centers:
the Gender Identity Clinic (GIC), waiting
times for treatment can be as long as
four years, and the compassion they
receive is, to say the least, lacking.
Patients summon up immense
courage to ask their GP for help
and then feel shunned, which only
compounds the feeling of isolation and
ridicule that they already encounter
from the general public.
It’s no wonder then that suicide rates
among the transgender community are
third of transgender adults, and half of
young trans people, attempt suicide.
Surely, this feeling of desperation is
health professional, to understand? As
I have seen from the countless patients
I have supported over the years, all
a listening ear, a little kindness and,
crucially, action.
GPs are well-versed in recognising
and understanding the concept of risk
should be able to comfortably identify
those patients who are at greater
due to delays in Gender Services.
GPs should feel able to comfortably
prescribe hormones to those patients
where it is felt their wellbeing would be
greatly improved by doing so.
report, as many as 650,000 people
in the UK are “gender incongruent to
some degree”, though the truth is that
the trans community is growing, with
the demand for access to GIC clinics
up 25-30% each year.
That is not to say, of course, that
this is a new condition, it’s just that
awareness is increasing, in part thanks
to media coverage of transgender
issues in recent years. As a result of
this increased awareness, people are,
take the secret to their grave.
Further steps, including calls for the
introduction of the option to record
gender as “X” in a passport, as well as
a movement towards non-gendering
noted where it is relevant - will go
a long way towards demystifying
the trans community which must,
ultimately, lead to acceptance.
experience of our country’s capacity
for change - just compare the common
approach to homosexuality in the 70s
and 80s, to our attidude today.
The transphobia from health
professionals, which this community
openly admits to experiencing, has
to stop and our best chance of this is
through education.
GP Training
As the primary care giver, all GPs
should be trained in how best to
support a patient presenting with
gender identity disorder. They should
know the protocols and encourage
patients to feel comfortable enough
to share this most precious secret
and, most importantly, they should
know what next steps must be taken,
which will ensure the patient feels
their needs are being addressed.
This approach will help prevent the
feelings of desolation that so many
of my patients have described when
leaving their GP surgery after sub-
standard treatment, but it will also
reduce the chances of that patient
seeking spurious medication online,
via illegal and unregulated sources. It
is very easy and appropriate for GPs
to at least substitute this treatment
with safer and legal prescription
medication and yet, currently, this
does not happen as a matter of
course.
As GPs, we are daily and continually
assessing and treating patients with
mental illness, and with hormonal
needs, such as contraception,
female HRT and male testosterone
replacement therapy. As such we are
well-versed in the indications, cautions,
contraindications and posology of
such treatments.
Guidance in the UK recommends
that GPs prescribe hormones so that
patients in need of this treatment
do not have to go without. There
are several tiers of care GPs can
undertake:
one third of transgender
adults and half of young
trans people attempt
suicide”
“Alongside the ignorance
among the general
population, trans people
face a second, more
of understanding among
the medical profession”
Pf | APRIL 2016 | 21

Dr Helen Webberley MBChB
MRCGP MFSRH is a GP
specialising in the treatment of
transgender patients on the NHS,
and via her private online clinic
gendergp.co.uk
22 | Pf | APRIL 2016

L
et’s speak frankly, for once!
No, I don’t mean to use this
column as a corner for my
own personal hang-ups. Well,
maybe I do. We can all identify
with a few things that get on our wick,
right - a few niggling irritations in the
workplace. Mine has to be ‘corporate
speak’, which has subtly penetrated
the world of sales, marketing, PR and
communications. What has happened
to good, honest, no-nonsense talking?
By this, I am not implying that the
corporate world is comprised of
Gordon Gekko and Donald Trump-
type characters - with blasé decisions
suited fat cats - but, my goodness,
sometimes you do wonder about
about the boardroom. The melting pot
of misleading platitudes and hollow
phrases is astounding.
I don’t know about you, but my heart
sinks every time I read an email, or
receive a call, which includes those
dreaded words ‘reaching out’ or ‘let’s
action that’ or ‘be more proactive’.
What does it actually mean?
There are countless other grating
examples, which I personally come
across on a daily basis: ‘going
forward’, ‘incentivise’ and ‘forward-
planning’ are just a few. To me, it often
feels like the person using them is
trying to skirt around an issue, sound
clever or befuddle me with wordplay.
I’m sure a number of healthcare
sector readers, especially in sales,
marketing or events, will be familiar with
such language. Why not just be upfront
- there could be nothing simpler than
saying in one sentence: ‘You need to
deliver X in order to achieve Y’, instead
of, ‘we need to be proactive, actioning X
to deliver ROI for Y’.
You might think I’m being a bit
pernickety, but these corporate
phrases mystify me, because there
seems to be a much simpler way to
say what you mean. Does it command
any more respect from colleagues and
clients by saying ‘low hanging fruit’,
rather than ‘this is an easy task’.
Having spent a few years battling to
hone my copy-writing and business
development skills, I like to think I
am in a position now to dispense
campaigning to eradicate the lazy use
of management speak. The results
are mixed, and - to be honest - even I
am guilty of occasionally quacking on
about ‘getting my ducks in a row’!
Ultimately, one of the great
challenges is trying to formulate
content, using a range of words which
don’t repeat themselves, or fall into
the trap of being cliche. After all, there
are only so many times you can use
‘fabulous’, ‘stunning’ and ‘iconic’ in
a press release, before the reader
becomes apathetic (or worse, thinks
you are wildly exaggerating).
I have come to the belief that clients
and buyers are shrewder than we
often give them credit for, especially
when it comes to understanding
the English language. They deserve
a far more direct and to-the-point
approach than many of us in sales and
communications-related roles would
be prepared to admit.
So, the next time you’re on the
phone or email, don’t look to ‘touch
base’, but rather, to ‘talk’. Who knows,
you might learn something.
Henry Rubinstein is Planning
Communications
“The melting pot of
misleading platitudes
and hollow phrases is
astounding”
Pf | APRIL 2016 | 23
Mind your language
“Does it command
any more respect from
colleagues and clients by
saying low hanging fruit”
PR Guru Henry ‘General Anaesthetic’ Rubinstein takes no prisoners on his quest
to save the Queen’s English.

A
lmost seventy years after
Nature
24 | Pf | APRIL 2016

be new weapons for us to control
multi-drug resistant Gram-negative
bacteria infections.”
One step beyond
Prof. Dong’s team originally
discovered an ‘Achilles heel’ in the
defensive barrier around Gram-
negative bacteria, and published
the results in June 2014. But exactly
how the ‘assembly machinery’ of
the defensive cell worked remained
unknown. Consequently, the team
received £1.7 million in funding from
The Wellcome Trust to continue their
work, and immersed themselves in
taking the research to the next level.
Using a highly advanced machine
called ‘Diamond Light Source’,
they set about investigating Gram-
This class of bacteria is one of the
it is so resistant to antibiotics; due to
the impermeability of its cells’ outer
membrane. This layer defends the
bacteria against immune system
attacks, and against antibiotic
treatment, enabling the bacteria to
survive.
Shine like a diamond
The machine uses diamond light - a
light source ten billion times brighter
than the sun - which allowed the
researchers to explore the cells in
atomic detail. By incorporating it,
the scientists were able to study
the defensive cell wall, then identify
and understand exactly how the
‘assembly machinery’ of the cell
worked, enabling them to build and
maintain the barrier.
“Beta-barrel proteins form the
gates of the cell wall for importing
nutrition and secreting important
biological molecules,” explained Prof.
Dong. “The beta-barrel assembly
machinery (BAM) is responsible for
building the gates in the cell wall.
Stopping the beta-barrel assembly
machine from building the gates in
the cell wall causes the bacteria to
die.”
The discovery could be the
breakthrough that saves the world
from creeping antibiotic resistance.
entire BAM complex. It paves the
way for developing new-generation
drugs,” said Prof. Dong.
Philip Butcher, Professor of
Molecular Medical Microbiology at
St George’s, University of London,
agreed: “This is an exciting discovery
and provides new avenues for drug
development. The impact on public
health and antibiotic resistance will
not happen for at least ten years, but
it is a great start, and an innovative
against antibiotic resistant bacteria.”
Dr Alejandro Palacios, Medical
accelerate the process of antibiotic
drug discovery and reduce
the burden of the progressive
development of antibiotic resistance.”
In WHO’s 2014 global report on
investigate the issue - it was revealed
that antibiotic resistance is a serious,
worldwide threat to public health.
Director-General for Health Security,
said that the implications that result
“will be devastating”.
While the discovery of the BAM
process could be the beginning of
new class of drugs still need to be
designed for this target to be realised.
Prof. Butcher says that - as with any
new drug - the cost to pharma of up
to $1 billion for developing new types,
and bringing them to market, must be
that money.
“Governments and agencies can
help by defraying costs to pharma, to
make it worth their while developing
new antibiotics. There are several
international government level
back against antibiotic resistance,” he
stated. “New initiatives are planned,
and have started, that provide early
R&D costs to academic researchers
in partnership with pharmaceutical
companies. These can make and
market medicines to hasten the
discovery of new antibiotics.”
Paving the way
This breakthrough has implications
beyond the development of a new
generation of antibiotics - it has an
impact on the understanding of other
diseases too. Unravelling the BAM
mechanism could help scientists to
understand more about human cell
dysfunctions linked to other disorders.
“Dysfunction of mitochondria
outer membrane proteins are
linked to disorders such as
diabetes, Parkinson’s and other
neurodegenerative diseases,” said
Prof. Dong. “The current work
may help us to understand human
diseases.”
Dr Palacios added: “Unravelling
the mechanics and architecture of
these BAM complexes in a model
understanding of other non-infectious
human diseases and may, potentially,
lead to the development of new
therapies for these illnesses.”
what this could all mean for the future
of drug discovery: “To mis-quote
Winston Churchill, ‘this is just the
beginning of the beginning.’”
Pf | APRIL 2016 | 25
“Stopping the beta-barrel
assembly machine from
building the gates in the cell
wall causes the bacteria to
die” Prof. Dong
“Unravelling the BAM
mechanism could help
scientists to understand
more about human cell
dysfunctions linked to other
disorders”

T
he government recently
published a new report
showing that life expectancy
at older ages in England
has risen to its highest level.
Consequently, the number of people
with dementia is increasing, because
people are living longer - reaching three
One in three people over 65 will
develop dementia, and it’s estimated
that by 2021, the number of people with
dementia in the UK will have increased
to around one million. Dementia already
costs the UK £24 billion a year. Add
all those statistics together, and it’s a
ticking time bomb, particularly for an
NHS that is already at crisis point.
The report from Public Health
England, ‘Life expectancy: Recent
trends in older ages’, revealed that
men and women can now expect to
live several years longer. In the autumn
of 2014, the Alzheimer’s Society also
published a major study on the social
and economic impact of dementia in
the UK, which predicted that there
would be 856,700 UK-based people
living with the condition in 2015.
According to the Alzheimer’s Society,
if current trends continue, and no action
is taken, the number of people with
dementia in the UK, is forecast to reach
1,142,677 by 2025, and 2,092,945 by
2051.
The ‘Prime Minister’s Challenge on
Dementia’ - launched in February 2015
- highlighted the progress to date on
improving dementia care, support and
research, and set out what the coalition
government wanted to see in place
by 2020. It wanted England to be ‘the
best country in the world for dementia
care and support’ and ‘the best place
in the world to undertake research into
dementia and other neurodegenerative
diseases’.
Challenging times
Advancing the research and
development of treatments for dementia
is a challenge. Alzheimer’s Research UK
(ARUK) is calling for the government to
increase research funding for dementia,
citing the fact that ‘dementia research is
underfunded compared to the amounts
committed to other conditions. This has
to stop.’
Current treatments only help to
manage some of the symptoms of
Alzheimer’s, and no new drugs have
been discovered for over ten years.
Drug Discovery programme, however,
focuses on ‘drug repurposing’, which
takes drugs that are already being
used to treat other conditions, and
tests their potential as a treatment for
dementia.
Dr Doug Brown, Director of Research
and Development at Alzheimer’s
Society said: “Repurposing drugs
that already work for other conditions
could provide us with a shortcut to new
dementia treatments.”
Working together
The past year has seen new industry
members join the Dementia Consortium,
and the launch of a $100m Dementia
Discovery Fund, brings together the UK
government, Alzheimer’s Research UK
and several pharmaceutical companies.
All will united to invest in pre-clinical drug
discovery projects.
Under the leadership of the World
Dementia Council, international
regulators have also convened to
discuss the streamlining of new
treatment assessments - essential in a
disease which is so time dependent.
26 | Pf | APRIL 2016
Dementia
dilemma
We are all living longer - much
longer - and dementia is on the
rise. How will the NHS cope, and
what will industry do to tackle this
devastating condition?

Hilary Evans, Chief Executive of
Alzheimer’s Research UK, said: “The
pharmaceutical sector has a vital part
and we have already seen a number of
investment in this area. It will be vital for
months, in order to draw investment
from the pharmaceutical industry,
treatments reach patients as quickly as
possible.”
A number of advances in dementia
research have recently been reported:
A 2016 study showed that a cancer
improves symptoms of Alzheimer’s
disease in mice.
Scientists at the Research Institute
for the Care of Older People are
vaccine which potentially slows or
halts the condition.
A recent study found that a protein
called GPR3 could become a new
disease.
Alzheimer’s Research UK says that
‘the UK has the opportunity to be
the best environment in the world
Increased research capacity
Development of better treatments
faster
Investment in a research
infrastructure that supports UK
universities to translate research into
treatments for patients.
Cameron quandary
Dementia’, David Cameron wrote: “We
cancer, heart disease and HIV/AIDS. I
want to see this work taken to the next
level.”
In February 2016, however, NHS
Dementia Enhanced Service (DES) from
take place from 1 April 2016 - means
that the £42 million resource earmarked
for dementia will be ‘transferred into a
of Alzheimer’s Society, said that for
been the poor relation within the NHS,
support”.
Hilary Evans said: “In recent years
we have seen dementia move up the
rates, there have been increases in
research. While this boost for research
has been welcome, dementia has
historically been under-funded, and
for dementia into line with other serious
health conditions.”
Dementia charities and support
care of dementia. Doctors on the front
line of elderly care are aware that any
result in a reduction, for instance, in
referrals to memory clinics; an essential
Dr Marc Mandell, consultant
psychiatrist in RAID team in Watford
hospital, said: “It is fundamental to
provision of care that patients are
physician at West Herts Hospitals NHS
trust, who has established a Dual Frailty
Unit, called Bluebell Ward, for patients
spent: “I would hope that it should not
be necessary to pay GPs to refer, as
this should be part of usual business;
it may be better to spend the resource
Hilda Hayo, Chief Admiral Nurse and
CEO of Dementia UK, said: “Good GPs
patients with dementia, however, they
up care system in place for people who
conditions, and tests their
potential as a treatment for
dementia”
already work for other
conditions could provide
us with a shortcut to new
dementia treatments”
Pf | APRIL 2016 | 27

Therapy Area/
Medical Sales
Representatives
Nationwide
Clinical
Trial
Educators
Telephone
customer
service reps
Reading
Respiratory
and diabetes
KAMs
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or email ukcareers@quintiles.com for more details.
www.quintiles.co.uk/careeers
Quintiles
a Fortune 500 Company
This is an exciting time to be a part of Quintiles.
You can make a lasting impact on your career, on the
industry, and on global health.
Call our Talent Management Team on 0118 450 1550
or email ukcareers@quintiles.com for more details.
We are currently recruiting in the UK and Republic of Ireland.
www.quintiles.co.uk/careers
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