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Patients AND Patience

Remembering the patient and putting the patient first emerged as a central argument at the #head2head PharmaTimes debate, Goldacre vs. Whitehead last night.

The debate tabled was: “Pharma is not getting its act together“. Dr Ben Goldacre, author of the book Bad Pharma, argued for the motion in one corner, versus Stephen Whitehead, the CEO of the ABPI, against.  Goldacre lost.

Whilst neither pulled any punches in stating their case, there was an undeniable focus in the room on the way in which Ben Goldacre has approached tabling his criticisms of the Pharmaceutical industry.

My overarching worry for Goldacre’s desired outcome of his ‘Bad Pharma’ campaign is about putting patients in a position whereby they can read everything about a drug.  They aren’t doctors or scientists and I cannot get out of my mind what happened when the now disgraced Andrew Wakefield created the MMR scare that caused children to die unnecessarily – all because parents were given a choice that they were not qualified to make.

Whilst transparency is absolutely critical if we are to ensure the best care for patients, it is essential for all stakeholders to agree on what they understand by transparency and work together towards a shared agenda that benefits patients. During the debate the ABPI acknowledged that the industry is not perfect but credit should be given to the work that has already been done towards ensuring transparency.  The pharmaceutical industry is at the centre of innovation, supplying new and evolving treatments, prolonging the lives and quality of life of people living with many diseases, including those once viewed as a death sentence, such as HIV.  Perhaps Goldacre should think about both patients and patience.

Is disease in the eye of the beholder?

Diseases, like beauty, are in the eye of the beholder

A lot of us spend our time working on disease awareness campaigns, but what is a disease?

You probably think that’s an easy one to answer – not so clinicians, policy makers and academics who are still trying to agree a definition. Indeed recently in the BMJ a group of Finnish researchers said that ‘disease’ “can be as difficult to define as beauty, truth or love”.

They go on to say that the definition of ‘disease’ strongly influences which drugs insurers and governments reimburse. So, in turn, the definition of ‘disease’ must strongly influence medical education, communications and marketing.

Research carried out in Finland among members of the public, doctors, nurses and MPs found that while some conditions were universally accepted as diseases – such as breast, lung and prostate cancer, diabetes, HIV/AIDS, schizophrenia and myocardial infarctions – others were not.

An equal number of people thought erectile dysfunction, infertility, drug addiction and premenstrual syndrome were diseases, as did not. And eight out of 10 said conditions such as ageing, grief and smoking were definitely not diseases. An interesting one seeing Cancer Research UK says smoking causes 86% of lung cancer deaths.

Unsurprisingly doctors were most likely to consider a condition as a disease, something which might contribute to the continuing controversy surrounding the ‘medicalisation’ of ‘normal life events’.

In the Finnish study, willingness to pay for a treatment from public funds correlated “very strongly” with whether patients, doctors, nurses and MPs saw a condition as a disease. The “large disagreement among the public, health professionals and legislators” as to whether the management of some conditions should be publicly funded might court controversy in this time of austerity.

The BMJ research says that understanding such differences in attitude can “inform social discourse” about several contentious public policy issues. And, of course, understanding these differences can also inform pharmaceutical marketing, communications and policies.

To a certain extent, we need to develop campaigns that recognise some diseases are, like beauty, in the eye of the beholder.

Eat or drink?

Sainsbury’s has struck a deal between family doctors and Roche under which overweight patients will be offered tours of selected stores with advice from nutrition experts.

‘Fat families’ are to be prescribed a visit to their local Sainsbury’s by GPs, where they will be taken by the hand and shown healthy foods.  This is a great example of joint working.

However, I do wonder whether this will suit the ‘fat families’ pockets if recent reports linking obesity to the recession are to be believed?

According to the Guardian –  ‘Austerity Britain’ is experiencing a nutritional recession, with rising food prices and shrinking incomes driving up consumption of fatty foods, reducing the amount of fruit and vegetables we buy, and ‘condemning people on the lowest incomes to an increasingly unhealthy diet’.

Why therefore is it not the same in France and Spain whose economic climate is significantly worse that the UK’s?

Britain is officially now the fattest nation in Western Europe, with more than a quarter of the population ranked as obese.

The Organisation for Economic Co-operation and Development (OECD) reports today that obesity rates are rising rapidly across Europe but the UK rate of 26.1 per cent is more than twice that in France, at 12.9 per cent.

Around one in every 11 deaths in the UK is now linked to carrying excess fat – 50 per cent more than the rate in France.

The French do not eat less saturated fat than the British and have similar cholesterol levels. It has been suggested that they are protected from heart attacks by drinking alcohol, particularly red wine.

These are very confusing messages for the consumer – particularly during National Alcohol Week launched by Alcohol Concern this week.

This link between obesity and the recession is probably true but also confusing.  Aren’t we all just eating comfort food to make ourselves feel better?  The more direct might say it is basic greed?

Experts also warned that the number of fatalities due to obesity may soon, for the first time, exceed those caused by smoking.  Given they stopped smoking in restaurants, perhaps they should stop us eating there too…

Where there’s HOPE

It’s the simple things that can make all the difference. How many times have we heard that? This month at Red Door Communications, we have been putting the old adage to the test and raising large sums of money for charity along the way.
One of our team, Lucy Yeatman, heard about the 10’10 challenge run by charity HOPEHIV. It’s a simple concept – everyone is given £10 and invited to find a way to turn it into £100 (and give the money back to HOPEHIV). It’s no coincidence that £10 is all it takes to establish a business in Africa where the charity delivers its’ excellent work.
We thought this was a splendid idea and aligned well with our company values which inspire entrepreneurialism, creativity and innovation. So we got the charity in to talk to us about their work before taking money from the company CSR pot and inviting the team to take part in the challenge.
To make the task more interesting we divided our staff into five teams and got them to pool their money and ideas to raise money.
On Friday, at our annual company birthday party they reported back on their activities so far and in a quite humbling display of teamwork and creativity they demonstrated how they are well on the way to raising thousands for charity – and all at relatively little cost in terms of time.
We’ll be sharing the results of their labours at the beginning of November. But until then why not have a read about the wonderful work that HOPEHIV does and the challenge people accept on a daily basis?


Innovation is now seen as the key to organisations’ health and survival. But the desire to do something a bit different, a bit clever and attention-grabbing isn’t as new as everyone seems to think.  It actually goes back to the pioneer of public relations Edward Bernays who used an early version of flash-mobbing to attract women customers to buy Lucky Strike cigarettes in 1920s New York where he orchestrated a march through the streets to persuade women it was a good idea to smoke. Permission to engage in such a creative fashion was as hard to get then as it is now, but arguably such innovation is more important currently in healthcare communications than ever before when clients want to stand out for the right reasons, not the wrong.

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Rulebooks and hand-sitters

Two initiatives that we’ve led at RDC in recent months have given me cause to stop and think about ‘rulebooks’ and whether these are helpful to the industry and patients or not. The first was the latest in our series of evening Darwin Debates. The aim was to discuss how a brand new pharma company might be structured to operate more effectively within today’s environment and specifically more freely in a digital world. Among other things, the group concluded that the new company would be much more focused on the end user (the patient); be able to forge a meaningful relationship with patients by trading more on its corporate heritage and importantly have clear and authentic values on which to base decisions, rather than be over-reliant on a complicated rule book.This resonated with the discussion at the second event. In response to the latest PMCPA guidance on Digital Communications, RDC hosted a workshop led by Dr Nick Broughton, Managing Director of When working in the new world of digital communication, companies need to work as hard on the ethical as the commercial justification for what they are doing. It is important to put the patient first and balance the justice, autonomy and chance of benefit against the risk of harm. There’s always a danger of jumping on the social media bandwagon without thinking things through, but there’s an equal chance of doing nothing because companies are paralysed by the current rule-based compliance paradigm. In the future, ethically competent companies will dominate in the digital arena, while rule-based hand-sitters will fail. To receive copies of the Reports from both of these meetings, email

At what price?

After all the consultation, speculation and demonstrations the much-heralded Health and Social Care Bill has been published. The reaction across the board has understandably been one of caution. While some of the debate raised genuine concerns about the scale and pace of change, some was based more on a mistrust of the Conservatives and their alleged desire to privatise the NHS. How far private providers will displace public ones remains to be seen, and whether the concept of ‘any willing provider’ will bring about the hoped-for improvement in care quality or the dreaded erosion of public control of health care is impossible to predict. Either way, it is an exciting time to be in healthcare. We’ll be watching the following key themes closely:Will the NHS focus on `the patient experience’ to determine the quality and application of healthcare? Or is it just paying lip-service to a concept that could redefine healthcare in the UK?Giving clinicians more control over which treatments and services they provide could benefit patients, but is GP commissioning the way to achieve this?The fragmentation of commissioning cannot be allowed to fragment access – no more postcode prescribing! With NICE acting mainly in an advisory capacity, what will happen to national standards of access and the current HTA programme?The government may argue that value-based pricing will remove some of these concerns, but no one has yet demonstrated how this will be calculated. Will we end up with a de facto cost and clinical effectiveness assessment of every new treatment that gets launched? To lead the debate, the pharmaceutical industry needs to continue to engage with the Department of Health about value. If pricing is to be based on value, what is value going to be based on? Central to this discussion has to be the patient. What do patients value in their medication? Efficacy and tolerability, yes, but what about administration, dosing and how treatments are accessed? Putting the patient at the centre of the value debate gives industry and health care providers a chance to translate the opportunity provided by the reforms into improved patient care.

Is 2011 the year of digital for pharma?

2011 sees the start of the Year of Digital Business Growth being launched by the Department for Business, Innovation and Skills. It’s great to see digital being recognised as a growth driver for many businesses and the economy. From our experience, the industry agrees that there is a substantial opportunity to engage with both patients and healthcare professionals through social media channels. However, there is a collective sense of “wait and see,” with many key pharmaceutical organisations looking to see what others are doing in order to understand precedent. Whilst lack of guidance is often cited as one of the main reasons that companies aren’t engaging with digital there is also a swell of opinion that social media is just a vehicle for communications so current guidance (which we all know so well) should apply and content be treated no differently.  It will be interesting to see how this debate develops in 2011.

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More than just spin

Today’s Financial Times includes a brilliant good news article about the PR industry. The article “A good PR consultant is worth the money” demonstrates the real investment and return that we can offer clients and why even the best in-house PR team can derive value from external consultants and agencies. I was delighted to see the comments “the industry has moved on from the early days of spin to embrace communications with investors, regulators, politicians and other discreet audiences”. The notion of spin and spin doctors, which became an all too fashionable phrase under New Labour, is still a stigma that is often attached to our industry. We need to continue to educate clients and investors about the real opportunities and gains that PR provides and escape the notion of spin once and for all! PR consultants and agencies inject new ideas, new angles and fresh thinking into their client’s business and their strategies, and should be part of the ongoing strategic direction of a brand.

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New beginnings?

It was spared in the first round of spending cuts announced on Monday, but the first hints of how the NHS will be affected by the new coalition government came yesterday in one sentence of the Queen’s speech introducing the NHS bill. Although it is difficult to draw any firm conclusions from just 27 words, what was said – and what was not – gives us some hints of the shape of things to come.

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