Pfizer…and innovation emergencies

The news that Pfizer is to close its R&D facility in Sandwich in Kent has shaken us from our sleepy winter hollows.

I’ve been watching the reactions and comments come over the wires as I am sure you have.  This is clearly a company going through considerable transition as it tries to change with the times – see the Reuters round-up of their results today for a good insight.  And essentially its the sort of hard-headed business decision that US companies seem prone to take about their global operations when restructuring.

So, a comment on Pfizer’s view of the UK as a place to do science?  No.  As a place to do business?  Possibly. 

But perhaps we should treat it as though it were the former.  For, ultimately, the impact is the same.  The loss of a world-class R&D facility in the UK.  As others have said today, it shows we need to up our game in how the Government and those across research work with industry.

Meanwhile…and no link between the stories is intended…I’ve been absorbing today’s report by the European Commission (see also BBC News)  ‘ Innovation Union Scoreboard’  It looks at the research and innovation performance of the 27 member states of the European Union.  The basic story is that the UK is rated an ‘Innovation Follower’ (just outside the ‘Innovation Leader’ category) and is playing catch-up with those ahead of it at a slower rate than its peers in the ‘Follower’ group. 

If you look at the country profile for the UK on page 50 it says some complimentary things about the UK having an ‘open, attractive, research systems’ and the stats show we are above average in the number of non-EU doctorate students (relevant to the immigration debate surely) and public R&D expenditure.  On most of the remaining indicators the story is not so good.

The European Commission, whose way with words is to be eternally admired, says the report is evidence of an ‘Innovation Emergency.’  I am not sure what to do in an ‘Innovation Emergency’ are you?  Other than look for my patent box of course.

An evening of industry – how the pharma business model is changing

So it’s 10pm and I’m busy here putting the final touches to the AMRC/INVOLVE report of the workshop we held in November which drew together patient views on health research regulation. 

This was at the invitation of the Academy of Medical Sciences as part of their review of regulation and governance but – and all credit to them – we agreed that AMRC/INVOLVE will produce its own independent report of the event and I hope this will be out before Christmas.

Anyway, that’s just a bit of context for you.  While writing, I listened to an excellent edition of ‘In Business’ entitled ‘Bitter Pills’ looking at changes in the pharmaceutical industry with a focus on GSK.  Its worth a listen if you are interested in how the business model for pharma is changing fast.

When good medicine is the casualty of hype and ignorance

I have just returned from the Financial Times’ offices, where I was the guest for their regular science podcast hosted by Clive Cookson and Andrew Jack (it will appear here later today).  The theme of the discussion was ‘Selling Sickness.’  Andrew was reporting on a recent conference of the same name that took place last month in Holland.  The programme and presentations from the conference can be found here and they made interesting reading as I was prepping last night.

For those who don’t know, ‘Selling Sickness’ is a term used to describe the way in which the pharmaceutical industry and other companies are said to collude with medicine and science to create markets for new and existing products.  The claim is that they do this either by exaggerating the existence of a condition, fashioning a disease out of what one might call the ‘unbearable ordinariness of being,’ or playing on the anxieties of both the worried well and unwell.  Sometimes all three of course, as I am sure many of us have witnessed.

It is a contentious issue and the discussion this morning was interesting.  That companies should be able to hop, skip and jump through the established routes of defining disease in order to market and sell products should be a concern to us all.

From a patient and medical research charity perspective the worry is more specific.  It is that such antics lead the genuinely-ill down the wrong road with regard to treatment, while encouraging the genuinely-well to believe the worst and follow a path that means taking unnecessary risks with their health.  Only through a combination of greater openness, better regulation and also patient champions working with and within companies can we perhaps avoid the worst vestiges of this.

But it also says something about deep trends and changes in our culture and society.  One in which the expectation is set that we must all carry some vestige of ill-health or impending sickness if we are to be ‘complete,’ to be able to exercise choice in its fullest sense in a world increasingly run on fear and neurosis.

The irony of course is that, as individuals, we are not good at taking medicine which is right for us.  Also, that people are generally lacking in the support needed to alter their treatment regime if and when their condition changes.  The challenge is not so much medicines wastage but how to ensure more effective use of existing medicines.  That certainly seems to be the evidence published toay by the York Health Economics Consortium and The School of Pharmacy, UCL.  

This study shows that waste from primary care prescriptions amounts to about £300 million a year.  As the authors point out, in the context of an £8 billion drugs bill in the UK, that’s not bad. Indeed, the report is at pains to say that the NHS is quite robust at tackling waste i.e the stuff that is thrown away.  The real issue, it says, is ensuring more effective use of medicine:

‘The new research finds that up to £500 million of extra value could be generated in just five therapeutic areas (asthma, diabetes, raised blood pressure, vascular disease and the care of people with schizophrenia) if medicines were used in an optimal manner,’ it says.

Pharma Times is reporting today that Earl Howe (who is speaking at our AGM tomorrow) last week backed the idea of a new medicines service attached to pharmacies to help improve medicines adherence when he spoke at the Pharmaceutical Services Negotiating Committee annual dinner (I miss all the best gigs in town).

Moving swiftly on, the research by the York and London teams could not be more timely.  For the last six months I have been involved in a fascinating piece of work stemming from the Royal College of Physicians report last year: ‘Innovating for health: Patients, physicians, the pharmaceutical industry and the NHS.’   Following its report, the College established a ‘Medicines Forum’ which was charged with looking at how the report’s recommendations could be taken forward.  This was to be done with the help of some sub-groups focusing on specific streams of work.

I am on what is called the patient sub-group – chaired by Harry Cayton and composed of patient representatives, pharmacists, GPs, regulators and others including Professor David Taylor from the School of Pharmacy at UCL.  We have chosen to focus on two issues: medicines concordance and; public involvement in research.  We are nearing the end of a series of enrgossing evidence sessions with a wide variety of people and organisations – from Boots the Chemist to the Royal College of Pharmacists, from the Science Media Centre to some of my members such as the Motor Neurone Disease (MND) Association – and will report to the College shortly ahead of a conference it is doing in February.

I feel that we are arriving at a good diagnosis of why people don’t take their medicines (it is as much to do with the quality of interaction with a health professional as with the quality of information).  We are now turning our minds to some solutions and recommendations.  I am sure that the need for more investigation and research into this issue will be one of them, and I hope that my members will take up the challenge as I know some already have.

But it has also highlighted for me that,  in the endless discussions about translational gaps in getting science from the bench to the bedside, we have spent far too little energy in the UK exploring how to ensure that it gets from the bedside to the, well, patient’s inside?  A simple process one would have thought.  But many influences can determine whether it happens fully, partially or not at all; I have already mentioned just two.  In the drive to create and develop medicines that meet real need, we must not forget the need to pay greater attention to this final, translational gap. 

That’s a long way from selling sickness I know.  But much more in the public interest, wouldn’t you say?

Capability Dave announces cluster therapy for research

Monday saw the Science Mnister, David Willetts, and Health Minister, Earl Howe, announce what are being called therapeutic capability clusters (research consortia)  at the ABPI/BIA conference in London.  PharmaLetter has an article on it and what I think is the formal news release can be found on Pharma Live.

Don’t be fooled by the PR speak which makes it sound as though this entity has just been launched.  As the MRC comment implies, work on getting this thing off the ground has been going on for months – well before the General Election.  But going public is significant in the sense it means that the potential hurdles standing in the way of its feasibility – like pharmaceutical companies sharing their data – have been overcome.

It’s unfortunate – he says in a rather grumpy way – that no one seems to have mentioned the involvement of some leading charity funders up to this point such as Arthritis Research UK.  In actual fact it is worth pointing out that the Office for Strategic Co-ordination of Health Research (OSCHR) has been very pro-active in engaging releveant charities in the two therapeutic areas concerned – inflammatory and immune diseases.

On the back of the spending review I would also say that yesterday’s news is quite an important political vote of support for OSCHR and it’s role in engineering partnership working for clinical research.  In the run-up to 20th October there were some whispers that OSCHR might change/migrate/vanish etc etc.  But this very tangible initiative and the up-front way in which it is being badged with OSCHR’s name by Ministers indicates that its place in the world is much more scure.

Science at the Labour Party Conference – Ed captures hearts but not science

In my potter around the conference exhibition this afternoon, I stumbled upon a stand for the ‘People’s Museum’ here in Manchester which charts the struggles of the working class and houses the Labour Party’s official archives.

I wish I had time to pop along if only to check whether my knowledge of political history is as good as I would like to think.

I won’t be the first to make the comparisons between the scenario inherited by Ed Milliband and that by Harold Wilson in 1963 - a demoralised party emerging from election defeat, the country faced by a massive deficit etc etc.

Almost to the day 27 years ago, Harold Wilson made his infamous ‘white heat of technology’ speech to the Labour Party conference in Scarborough. ‘The Britain that is going to be forged in the white heat of this revolution will be no place for restrictive practices or for outdated measures on either side of industry’ is what he actually said.

Brian Walden recounts in a BBC Online piece that later that day – 1 Oct 1963 – a trade union leader remarked that Harold Wilson had ‘captured science’. A strong statement indeed.

Delegates watching Ed Milliband on one of the exhibition tv screens

Ed Milliband’s speech today will no doubt be marked down as the ‘new generation’ speech and I understand his need to speak to his party above all at this time.  But given the impassioned speeches I have heard from shadow ministers this week about the need for a good story on growth and the importance of science in that story I was disappointed that we did not even get a hint of either in the Ed’s opening gambit.

I looked back at the programme for the Scarborough Conference and noticed that Dick Crossman was also speaking on the same day as Wilson about the organisation of university research.  Strange how these issues are cyclical, a shame that a sense of history is lost to us when facing the current.

I think Will Hutton said last night: ‘It is only science that can save us.’