Researchers at the UCSD Moores Cancer Center in La Jolla and the four other UC campuses with medical schools yesterday launched what could become one of the nation's largest studies on breast cancer.
The Athena Breast Health Network will spend several decades looking at screening and treatment for 150,000 women in California. The coordinators hope to expand their project by enlisting participation from outside medical centers.
They aim to identify factors that lead to development of tumors, unlock new therapies for the disease and generate mountains of data that will take years for cancer experts worldwide to analyze.
“This is an attempt to take advantage of the large scientific, medical and patient resources that the University of California has,” said Dr. Barbara Parker, director of oncology services at the Moores center and the main investigator for the new network at the University of California San Diego.
Breast cancer is probably the largest cancer killer in women in the Western world, with 40,000 women dying from the disease in the US every year.
It's difficult to see how much impact this study will have, but it could be important if better risk factors or improved diagnosis at an earlier stage occurs. The earlier cancer is detected, the more likely you are to achieve a cure or remission.
Like many, I missed this press release on Friday afternoon, but it seems that at least there was some media pick up, such as the article from The Star Tribune in Minnesota.
Any time you see the words'study halted over safety concerns'you know the news isn't going to be cheering. In this case, six patients experienced heart symptoms, the symptoms of which include shortness of breath and fatigue, along with swelling in certain parts of the body. Now, granted cardiotoxicity is a known complication of anthracyclines (AC), which were also taken by the patients in addition to the tested drug, Avastin (bevacizumab).
Clearly, we will have to wait and see if the effect was due to AC alone or whether Avastin potentiates the effect in any way. Avastin has been show to increase vascular side effects such as hypertension, a known adverse event associated with the VEGF class of drugs, but the news isn't good for Roche/Genentech, especially after the failure of the drug in colorectal cancer earlier this year, also in the adjuvant setting:
"Enrollment into E5103 began in November 2007 and 3,439 of the planned 4,950 patients have been entered into the study."
Of course, as luck would have it, the cardiac issues arise after nearly 70% of the patients have been enrolled, exposing the majority of them to the combined effects of both the anthracyclines and the bevacizumab toxicities. While 6 patients out of 3,439 isn't a lot (less than 0.2%), it will be interesting to see whather this is an expected anthracycline problem or an increased potentiated by two drugs that impact the vascular system.
One of the most useful things I gathered, intelligence-wise, for a client project this week was from following some cancer patients stories via their their blogs. This is social media monitoring at is best.
Why?
Because they tell it as it really is, no strings attached...
What the treatment involves, the practicalities, the side effects, the tests, and everything else in between, including the weather and how the medications affect things like taste, for example.
I learned that the 3 infusions needed for their particular protocol took seven hours. Ouch! Imagine how tiring that would be for the patient and caregiver who was with them shepherding them around , the nursing staff monitoring it and everyone else involved?
As we go about our daily lives we forget how easy it is to take life for granted. This sort of real information keeps us human and our feet on the ground.
The rival product in development is a pill. You can pop it at home over breakfast while watching the morning news. Sometimes we forget that simpler is easier but not always better, though.
For short term treatments, remembering to take the pills is relatively easy but over the long term, compliance becomes a problem, either because you feel good and forget to take the pills or because chronic therapy can induce its own side effects and symptoms and perhaps you feel the need for a break from the relentless of it. After all, how many of us forget (or can't be bothered) to take antibiotics in the third week of a course, let along consider daily consumption for a more chronic condition?
Thus, I wasn't entirely surprised to see an article in the FT this week about the Novartis deal with Proteus, a company who focuses on compliance solutions:
"The company is testing technology that inserts a tiny microchip into each pill swallowed and sends a reminder to patients by text message if they fail to follow their doctors’ prescriptions."
Now, that may sound a little like Big Brother is watching you and the cynical might think that companies are more interested maintaining their profits by keeping refill prescriptions on schedule, but for some serious diseases it may also affect outcomes. In my experience, with acute conditions approximately 15-18% of patients forget to take all their pills, but this sadly rises to 25-35% with chronic therapy over time.
Another way companies can track the data from their own products is analyse the data from their Patient Assistance Programs (PAP). One time when I was working on the industry side as a marketer, we did this and were surprised to find that even with free drug, the compliance rate was about 25% for a cancer therapy taken chronically after about 18 months or so. We knew this would only get worse over time as patients feel better and think their cancer is in remission. That was a sobering thought because the risk of the cancer coming back is high unless the oncogenic clone was suppressed. It also underscores the importance of continuous patient and physician medical education; perhaps this is where patient programs through selective use of social media can be effective in reaching a wide audience. The message is never ever take anything for granted.
Think about the impact of chronic therapies for life threatening diseases like cancer, for example. As more companies are developing oral small molecule tyrosine kinase inhibitors (TKIs), so cancer moves from an acute condition to a chronic one. However, with TKIs their mechanism of action is based on constantly competing with ATP to suppress the oncogenic clone and keep the disease in check. This means that not taking the drug over time can lead to a return of the disease, new mutations and possibly even major relapse or patients becoming refractory or resistant to their therapy. That is the last thing an oncologist wants to see.
There are other ways to improve compliance, including Pharmacies tracking refills over time and phoning you with a friendly when you are overdue or chips in the bottle caps instead of the pills themselves. The loose pill bottles favoured in the US actually contribute the problem. Unless you get into an almost religious routine, it is easy to forget sometimes whether you took your daily dose or not and we haven't even considered the effect of patients deliberately self medicating less with to save money or because some side effects were bothering them. At least the weekly or monthly blister packs common in Europe make it easier to remind oneself to take the prescription on schedule more easily.
Ultimately, though, the goal with these tools is about helping to improve patient outcomes. This is a trend we are probably likely to be seeing more of in the future.
The best overall tumor response was partial response, which was seen in 37.9% of patients by independent assessment and in 46.7% by investigator assessment. Stable disease was seen in 48.3% of patients by independent assessment and in 43.3% by investigator assessment. Median time to tumor progression was 5.5 months by investigator assessment and median survival was 14.9 months. The data from this trial corroborate findings from a recent randomized phase II trial, which suggested improvements in efficacy variables, including survival, when ASA404 1200mg/m2 was added to standard therapy for advanced NSCLC. The manageable safety profile, lack of adverse pharmacokinetic interactions and efficacy outcomes seen in this single-arm study suggest that ASA404 1800mg/m2 is a viable dose for future combination studies.
This week I'm snowed under with work, so was unable to attend the ECCO/ESMO conference, but have been following the key updates on Twitter and via press releases. Here are a few snippets of data I found interesting and some analysis/commentary:
1) Bayer announced some updated Phase II data with Nexavar (sorafenib) in breast cancer.
They found that when combined with Roche's capecitabine, it makes a significant difference to the time women live without their disease worsening.
Pfizer's Sutent (sunitinib) also had positive Phase II data in breast cancer in the past, before concluding that the Phase III data was unlikely to show a significant effect. We should therefore probably wait for the phase III sorafenib data before getting over excited.
2) The PI3K pathway might be as a factor in poor response or resistance to HER2-inhibitors such as trastuzumab.
"Of the 8,000 genes tested, we found that only knock down of PTEN conferred resistance to Trastuzumab. Decreased PTEN expression results in hyper activation of the PI3K pathway. Significantly, activating mutations in the gene encoding the p110a catalytic subunit of PI3K (PIK3CA) have been identified in some 25% of primary breast cancers potentially mimicking the effects of PTEN loss. Indeed, overexpression of the breast cancer-derived mutant PIK3CA (H1047R) also conferred resistance to Trastuzumab in cell culture. These findings are consistent with a major role of the PI3K pathway in the development of resistance to trastuzumab."
It makes sense to consider a) predict whether patients are likely to respond to therapy upfront and b) consider multiple therapies to overcome the development of resistance.
3) Impact of microsatellite instability (MSI) positivity and the presence of KRAS and BRAF mutations on colon carcinoma patients.
It has been observed in the past that stage III colon carcinoma patients with the BRAFV600E mutation had a significantly worse prognosis, based on the results of a study that aimed to assess the impact of microsatellite instability (MSI) positivity and the presence of KRAS and BRAF mutations on colon carcinoma patients.
The current study reported on 258 patients with stage III colon cancer who were treated with surgery followed by a 5-fluorouracil-based adjuvant therapy. KRAS mutations in codons 12 and 13 were determined by PCR followed by direct sequencing, and MSI status was determined by typing the BAT 26 marker (positive in 99% of MSI-positive white patients). It was concluded that tumor mutational status should be determined to predict survival more accurately in patients with colon carcinoma.
We will probably hear more about BRAF as a predictive marker in CRC, in addition to the KRAS mutation that was all the rage at ASCO earlier this year. Predicting responses to therapy is one thing, but the real need for patients going forward, is to find new therapies that will overcome the resistance induced by these mutations.
4) Is Iressa (gefitinib) making a comeback in NSCLC?
Two interesting abstracts (O9002 and O9003) demonstrated that analysis of four phase III trials comparing gefitinib monotherapy (250 mg orally per day) versus chemotherapy (docetaxel alone or carboplatin/docetaxel) produced marked efficacy of gefitinib in NSCLC patients with EGFR mutations. The benefits of gefitinib in prolonging progression-free survival (PFS) were even greater in Asians with mutations than in non-Asians with mutations.
It is good sense that EGFR testing should be performed in NSCLC patients in order to select for therapy and ensure that those most likely to respond are treated. There is little point in giving a drug to patients who are unlikely to respond, so the value of biomarkers is clearly demonstrated in this setting.
5) Bayer's shows activity in renal cell carcinoma
In addition to sorafenib, Bayer also have an oral multikinase inhibitor, regorafenib (BAY 73-4506), in development, which produced disease regression or stabilization in 81% of patients in 1st-line treatment of patients with metastatic or unresectable RCC
"Of 48 patients evaluable for efficacy, preliminary data indicate a partial response (PR) in 33% (23% confirmed PR) and stable disease in 46% of patients."
Renal cell carcinoma is fast becoming a) a useful tumour type for testing proof of concept for new drugs in development, but that also means that b) that the market is becoming very competitive for such a small indication. I'm not sure what Bayer would usefully gain by having two such products on the market in the same tumour type, since it potentially cannibalises their sorafenib market share.
6) Amgen's motesanib (AMG-706), a VEGF inhibitor looks active in metastatic breast cancer
"Motesanib in combination with P (paclitaxel) or D (docetaxel) appears to be tolerable and shows evidence of antitumor activity in pts with advanced breast cancer. Coadministration with either P or D had no major effect on motesanib PK."
I've been following this agent for a little while as it started cropping up in searches for clinical trials in multiple tumor types. It appears to target VEGF, KIT and PDGF. Poster PD-5029 is a dose finding study, so the emphasis is on adverse events and tolerability rather than efficacy, but 28-29% response rates this early are interesting at this stage. This is one agent I'll be following more closely as more results are published in the future.
There are probably some other interesting abstracts out there, but those are the ones that caught my eye in the news this week. Anyone who saw some other data is welcome to mention or discuss them in the comments below!
The need for data speed has inspired O'Reilly to come up with a new phrase, "Web squared," to describe the evolution of the Web as we know and use it. O'Reilly and John Battelle, founder of Federated Media Publishing, coined it in a white paper preceding their Web 2.0 Summit conference in San Francisco next month.
This article made me wriggle - too much of it was very familiar to me.
However, many people in Pharma and Biotechnology are not digitally savvy, so I wonder what will happen as there are more M&A's, consolidations and redundancies... being uber connected can sometimes be to your advantage in the new digital networking world.
Having written about hedgehog signaling in cancer a few times on this blog (see here, here and here for examples), including it's potential role in CML, it came as no surprise to see some very exciting new data presented in the New England Journal this month.
The other week, while attending the excellent Rodman and Renshaw Healthcare conference in NY, I was fascinated by one particular presentation by Curis, whose hedgehog inhibitor (GDC-0449) is being developed with Genentech/Roche, not to be confused with their pan PI3K inhibitor (GDC-0941). The initial promising indications include basal cell carcinoma and medullablastoma, both rare but fatal diseases. Curis illustrated their development program, including the hedgehog inhibitor as thus:
In the NEJM articles, phase I data in basal cell carcinoma (BCC) and medullablstoma (MB) was reported by van Hoff et al., and Rudin et al., respectively.
The BCC patients had locally advanced and metastatic disease and received either 150mg or 270mg per day and showed a median of 9.8 months on study at the time of reporting. Of the 33 patients, 18 had an objective response (2 CR, 16PR), giving an ORR of 55%. Typical drug related adverse events seen in 6 of the patients included fatigue (4), hyponatremia (2), muscle spasm (1) and atrial fibrillation (1).
Medullablastoma is the most common malignant brain cancer seen in children, with a typical diagnosis around 5 years of age. Rudin et al., reported on a case study of the cancer found in a 26 yo man who was refractory to multiple therapies. Analysis of tumor specimens suggested activation of the hedgehog pathway. Treatment with GDC-0449 resulted in rapid but transient regression of the tumor and reduction in symptoms. A trial in children with medullablastoma was therefore recommended, since use of a targeted inhibitor of a pathway implicated in malignant transformation may prove a useful new approach.
In their succinct editorial, Dlugosz and Talpaz highlighted some important points. In particular, they noted that blockade of the hedgehog pathway could lead to a greater degree of selectivity and fewer side effects in the treatment of cancer compared with conventional chemotherapy. The pathway is also involved with numerous processes associated with embryogenesis but becomes largely inactivated in adults, except in some cancers when it appears to be reactivated. Overall, they described hedgehog inhibition as a promising new approach in BCC and medullablastoma that are well worth pursuing.
From a marketing standpoint, this approach continues the concept applied by others such as Novartis viz Gleevec in CML and GIST and Ilaris in Muckle Wells Syndrome, where the drug targets the actual cause of the disease and has a high efficacy rate, yet the market itself may initially not look particularly large or attractive. However, I would argue that it is easier to own a high share of a small market than try and achieve a small share of a very large and competitive market. Of course, the commercial value also increases significantly if the therapy becomes chronic or larger new markets evolve after the initial fast track approval. Neither basal cell carcinoma nor medulloblastoma offer Curis and Genentech larger cancer markets initially, but the elegance in the proof of concept for targeting the hedgehog pathway is an important one and more opportunities may follow later.
Von Hoff, D., LoRusso, P., Rudin, C., Reddy, J., Yauch, R., Tibes, R., Weiss, G., Borad, M., Hann, C., Brahmer, J., Mackey, H., Lum, B., Darbonne, W., Marsters, J., de Sauvage, F., & Low, J. (2009). Inhibition of the Hedgehog Pathway in Advanced Basal-Cell Carcinoma New England Journal of Medicine, 361 (12), 1164-1172 DOI: 10.1056/NEJMoa0905360
Rudin, C., Hann, C., Laterra, J., Yauch, R., Callahan, C., Fu, L., Holcomb, T., Stinson, J., Gould, S., Coleman, B., LoRusso, P., Von Hoff, D., de Sauvage, F., & Low, J. (2009). Treatment of Medulloblastoma with Hedgehog Pathway Inhibitor GDC-0449 New England Journal of Medicine, 361 (12), 1173-1178 DOI: 10.1056/NEJMoa0902903
Dlugosz, A., & Talpaz, M. (2009). Following the Hedgehog to New Cancer Therapies New England Journal of Medicine, 361 (12), 1202-1205 DOI: 10.1056/NEJMe0906092
Here's an interesting presentation on a new method and approach looking at the early detection of lung cancer, sent to me by Mary Canady of Comprendia:
Essentially, the test samples deep lung sputum and appears to label it more accurately than currently available methods. You can see the difference between normal cells and lung cancer cells in slide 14.
The CyPath test is currently being evaluated in the field in New Mexico via a pilot lung cancer screening study in 225 military veterans to detect early lung cancer, with completion in November this year. A second, larger study will commence in January 2010, in 3,500 patients with an estimated completion of March 2011. FDA approval will therefore likely be around 1Q12 based on the current timelines.
If the results from these trials are positive, then it is possible that the CyPath may eventually become a new annual screening test for lung cancer in the same way we currently have PAP smears for cervival cancer and PSA for prostate cancer. Lung cancer is much more prevalent, especially amongst smokers, and is the single biggest cancer killer in the developed world. Detecting it in earlier stages rather than in the metastatic phase would likely lead to improved survival from the disease in the long run.
Of course, it's early days yet and time will tell whether the test is sensitive enough or not.
It isn't clear whether it will detect small cell from non-small cell lung cancer or even mesotheliomas or whether they all get lumped together as one amorphous 'lung cancer' group,
It's an approach that's well worth experimenting with given the time taken to develop a major tumour and the link with cigarette smoking.
The other day I was browsing the pharmacy shelves for anti-inflammatories and debating whether to purchase a branded product or a generic. Of course, the pharmacy own label brand was suitably placed most conveniently at eyeline, whereas the competitors were housed above and the branded products awkwardly placed at the floor level.
There was inevitably difference in the prices and a wide range of formulation choices (soft gel capsules, hard pills, capsules, caplets etc). None were dispersible, which was what I was ideally looking for.
In the time I spent thoroughly investigating the options, 3 or 4 people walked past, paused briefly and grabbed the cheapest (and most lurid) box on display, and marched off with their selection.
Back in the office, I did some research on generics. In the last few years we've all become accustomed to news about pipeline failures in phase III, a dearth of new products coming to market and various market pressures on patents, prices etc.
But what of generics, what's the trend there? I'm particularly interested in this because a number of blockbuster cancer drugs have either just gone off patent (eg sanofi-aventis's Eloxatin) or are about to within the next 12-18 months (Taxotere, Doxil, the aromatase inhibitors etc).
Taking a look at the industry PhRMA site, I found some interesting data in several places about the growth of generics, which you can see consolidated graphically below:
Now, this data only applies to full years already reported, so with a number of blockbusters going off patent, we can expect the share of generics in the market to increase. Is it any wonder that prices of new therapies are rising as the market pressures on profit margins increase?
It's going to be an interesting 18 months ahead as we watch the industry adapt and try to do more with less. Ultimately, those who are smart and creative will more likely to be successful.
The convergence of Pfizer and AB Science in the tyrosine kinase inhibitor market is an interesting conundrum.
The market for tyrosine kinase inhibitors (TKI) is one that I keep an active interest in having worked in new product development and marketing at Novartis Oncology bringing Gleevec to market in CML and GIST.
I was, therefore, fascinated to read that AB Science, a fifty person, privately held company based in Paris, launched the first targeted cancer therapy for dogs in June this year. Masivet (masitinib) is a TKI with approval by the European Medicines Agency (EMEA) for the treatment of non-resectable grade 2 or 3 mast cell tumors (mastocytoma) in dogs. Up to 20 to 25 percent of skin tumors in dogs and cats are mast cell tumors
In clinical trials, Masivet increased the survival time of dogs by 300 days compared to placebo, and after two years the survival rate was 2.5 times that of dogs receiving placebo. The drug also demonstrated increased progression free survival. Masitinib is currently under review by the FDA veterinary division for approval in the U.S..
Animal health is big business and a growing market, particularly in the United States were pet owners are willing to pay for drugs and treatments that will maintain the life of their pets. There are over 130 million dogs and cats in the United States, and 4 out of every ten households own a dog.
It should come as no surprise that major pharmaceutical companies are players in this field. In 2008, Pfizer’s animal health division had $2.89B of revenue compared to $2.41B from human oncology drug sales. In June 2009, AB Science did a pan-European launch of Masivet in Europe, but at the same time Pfizer obtained approval in the U.S. for their TKI, Palladia (toceranib), for same indication i.e. the treatment of mast cell cancer in dogs. AB Science are still waiting on FDA approval for their drug.
Whether AB Science, who have publicly stated that they don’t wish to partner with other pharmaceutical companies, will be successful in the U.S. animal health market when their product is approved by the FDA remains to be seen. In the U.S., Pfizer Animal Health have first mover advantage, started selling product in July and have the infrastructure, sales force and marketing to capture market share. It is hard to see how a small company can compete with an industry behemoth.
At Icarus Consultants, amongst other things, we work with pharmaceutical, biotechnology and healthcare companies on developing market entry strategies into the U.S.. What we see are many examples of business plans that are destined to fail. As John Mullins of London Business School describes in his new book on “Getting to Plan B: Breaking Through to a Better Business Model”, many companies have flawed business plans that are the equivalent of selling Coke to kids in China. It sounds attractive on paper given the market size - "all we need is 1% of such a large market", but without the resources to distribute or market the product or a deep understanding of which segments to target (and how to reach them), it is a fundamentally flawed business plan. The same could be perhaps said for AB Science seeking to compete against Pfizer in selling animal health drugs for dog cancer in the United States.
What makes the convergence between Pfizer and AB Science even more fascinating, is that AB Science are developing masitinib for human use as well. They are currently in phase 3 clinical trials of masitinib in Gastrointestinal Stromal Tumor (GIST) going head to head against Novartis’ Glivec/Gleevec for first line use. Not only is this market already dominated by Novartis, the leading second-line treatment for patients who eventually develop imatinib resistance is Pfizer’s Sutent (sunitinib). Other major pharmaceutical companies that have drugs for this indication include BMS with Sprycel (dasatinib).
It will be interesting to watch what happens to AB Science over the forthcoming months as they go it alone against major Pharma companies with very limited resources.
Will they make a success of it or will they end up going to the dogs?
That's the $64M question I got asked by a client this week and also on the panel at Pharma Marketing today (I'll add the link here later).
We don't know the complete impact yet because no bills have been passed, although much has been debated, often furiously, both in Washington and amongst ordinary people in forums, social media and on the street. Debate is a good thing, it means people care and are energised and involved in the decision making process.
After some thought, here's my simplified perspective:
In general terms, I think we may well see some major impact on Pharma marketing in the following key areas:
1) Coverage expansion – increased coverage for all Americans means that there may well be increased volumes in prescriptions, but also a shift in payer mix.
The companies who develop an optimised reimbursement and formulary strategy will do well here.
2) Government rebate plans and pricing - increased volumes may lead to pricing controls.
Companies need to plan for this going forward. Expensive treatments are more likely to be limited compared to cheaper alternatives. The gravy train of premium priced new therapies, irrespective of effectiveness, is likely to slowed.
3) Comparative effectiveness – the stimulus package included plans for funding of comparative effectiveness under ARRA.
The results of this approach could change which drugs are approved on formularies, based on CER. Companies with solid health economic data for their products are likely to do better.
4) Follow-on biologics – Congress is likely to include a provision in the reform bill for a new FDA pathway for the approval of biologics. Current proposals seek to limit biologics to 12 years of exclusive use.
Companies will need to plan ahead both for existing biologics on the market and future ones in R&D. The new laws will limit future profits if enacted and allow generics to be used earlier. Currently, drug therapeutics have protection for 17 years.
5) Prohibition of branded/generic settlements – proposals to limit settlements between branded manufacturers and generics companies may speed up the availability of generic competition.
Marketers will need to develop life cycle management plans earlier to maximize new formulations and indications prior to the introduction of generics. This will favour large manufacturers over smaller players because they have the resources and budgets to speed up development to make up for lost of future earnings.
6) Sunshine laws – proposals requiring manufacturers to declare relationships with physicians will increase transparency are included in several reforms and enactment of a similar approach already exists in 6 States by law.
This will impact Pharma companies through systems changes and increased compliance controls and oversight.
Get a team of 30 people together and ride 25 miles in support of Tufts Cancer Centre for Research in support of kid's cancer with a goal of raising $10K.
And then you are faced with weather like this:
And a start line like this:
And a very soggy finish line like this:
Yikes! This is the incredible story of my Twitter buddies with the heart of gold @stales and @lilpecan. I've been following both for a little while now. @stales is a 3 time cancer survivor herself, yet both give selflessly in the cause to help others. Here's @stales herself on the left - isn't she charming?
I followed their progress via Twitter and Posterous after sponsoring them myself on Saturday. How could one not, especially in that stinking weather?
It was gratifying to see them finish safe and sound and tonight watch a cute video of thanks from a child at Tufts:
So here's the deal. These lovely ladies are a few dollars short of their goal. I don't normally mention fund raisers on this blog but a) they're friends and b) it's a great cause!
Every $5 counts, so who would like to help the lovely ladies and Tufts Cancer Center for Children in the Cycle for Life?
If you feel like joining in the fun, you can chip in here and make their valiant efforts all the more worthwhile.
Sen. Max Baucus (D-Mont.) officially introduced his $856 billion healthcare reform bill today, which does not include the creation of a public insurance option.
The bill will be marked up by the Senate Finance Committee next week.
HealthMap is a useful new tool for tracking outbreaks of infectious diseases.
You can find it on the web or even better, as a free iPhone app, so I thought it would a good time for taking it out for a test drive. Downloading was fast and easy, and you're up and running in minutes. What do you get?
First of all, it asks for permission to find your current location and maps known reports or outbreaks near you like this:
The use of red and green pins is a bit of a pain for those of us who are colour blind, if I was in Australia or Africa, I might not know where I am relative to the other pins, but at least in the USA, one has a chance of working out which is the home pin!
Since I know where I live I can immediately see there is activity in Montclair and Toms River. Clicking on the Montclair pin shows more detail:
No surprise to find a suspected swine flu outbreak given the University location there.
Not all of the pins are swine flu though. Further south in Toms River, the situation is a little different, with a West Nile outbreak reported from migrating birds, for example:
Using the List view, you can also see more detail, such as Hepatitis B in Toms River and swine flu in around Cornell University in NY. All fascinating information.
Interestingly, the app allows you to submit any potential outbreaks yourself. This would be very useful for E. Coli poisonings, particularly if they warn people early enough to avoid a wider scale problem developing:
I particularly like the alerts feature, which allows you to receive information on a particular topic of interest. This might be Lyme Disease, if you live in a rural area or E. Coli outbreaks, or whatever is common in your area.
You can also search by keyword or disease. On typing in E. coli, the app took me to the UK and showed a map of England and Wales with 2 known outbreaks. Clicking on the pin in England brought up information on two outbreaks in Surrey, except that the pin was located somewhere NE of Nottingham in the Midlands, a bit disconcerting! For US readers, Surrey is a county located south of London so the pin was maybe 150-200 miles off target.
Overall, I liked the app. It was fast, intuitive and easy to use, didn't crash on me and provided a ton of interesting and useful information relating to infectious disease outbreaks. I was pleasantly surprised. It's also free and for those of you who do not have an iPhone, there is also a website for more granular information.
It's good to see some high quality and useful web 2.0 apps coming out in the health space. Let me know if you come across any others, it's always good to see what is out there.
This is an extremely topical area where we are rapidly seeing a complete shift in the media arena as a result of innovations in influence and disruptions in technology. The world as we know it is changing and new shifts are evolving.
I personally predict that the whole concept of an advertising industry is about to be turned on its head and that this is already more well advanced than many industry players are aware of.
In the case of Social Business Design this is an area that has been bubbling under for about 18 months with a range of different tags, such as Enterprise 2.0, but it never really gelled together. There were differences of opinion on who the market was, how to approach it and what exactly did it constitute. Was it simply setting up a corporate blog, an internal wiki and a customer forum or was there more to this area?
So much of the theory and practice that resides at the core of Social Business Design sounds like the same principles that successful villages and communities existed upon largely up until the early 18th Century. For these villages, commerce was very much about the community, and conversations and relationships.
This blog is published by: Sally Church, PhD of Icarus Consultants, Inc. The contents of this blog are the intellectual property of the author and all rights are reserved. No commercial use, copying or distribution is permitted without the author's express permission.
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Icarus Consultants is a management consulting company focusing on marketing strategy and new product development to the Pharma and Biotech industry. We focus on specialist areas such as oncology, hematology, immunology, respiratory and HIV.
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