Pharma Strategy Blog

The ravages of smoking and cancer...

We all know that long term exposure to chemical insults and carcinogens from smoking and alcohol can act as irritants, leading to biochemical changes that can induce the development of hyperplasia, and potentially, carcinomas.

Over the weekend I was shocked to learn that Alex "Hurricane" Higgins, former World Snooker Champion, had passed away aged 61 from throat cancer.  He was an incredible talent who will be sadly missed and remembered for many years to come.

I wrote a bit more about it here: be warned though, the before and after photos are rather distressing :(

Simplifying data capture and blog post workflow

Recently, I've had a lot of enquiries as to how I manage to write so many blog posts, either in terms of finding the time or staying current.

The answer is simple - I use tools to help simplify and minimise the effort involved.  You could also use this kind of web 2.0 approach for creating a database and tracking data, intelligence, keeping current if you work in the Pharma or Biotech industry, whether a scientist, a marketer or a PR professional.  Of course, you could spend hours Googling stuff or reading a few health sites online, but there are other ways to stay ahead of the pack.

The key parameters at play here can be summarised:

• Gather data
• Process and understand information
• Perform analysis
• Generate Insights

Far too many people often only do the first two tasks, but without analysis and insights, the data means very little.  So what are the tools of my trade?

1. Evernote

I've talked about Evernote in the past, which is a nifty data capture tool we use daily here at Icarus Consultants. They have both free and premium versions to suit everyone's pocket. 

When starting projects, we clip relevant information from the internet into a new Evernote Notebook and gather it all in one place. You can use a desktop or a smart phone for this task and dump as much information as you like into it for later searching. This makes it easier to digest when looking at the big picture and gathering ideas and seeing trends.  You can also search your own database for existing information, which is very useful for blog posts or writing reports around a topic.

I often create and write blog posts in Evernote too.  The research information is already there and it's straightforward to use the editor as well, as backing up and synchronising the information across multiple platforms.  We've all written something in Word or a Blog Editor and lost the content >.< but l have found Evernote more reliable for saving information, which can then be cut/paste with minimal editing into the Blog platform or Office for reports. I also have a bunch of articles, reports and blog posts that get part drafted and finished later, acting as a useful repository for gathering ideas.

Other good uses? Need some information on the road while talking to someone? A quick search in the app my iPhone will usually bring it up.

The other side of the coin is generating and gathering data. I've mentioned that you can clip research to an app such as Evernote on the go, but I also have a LOT of information in RSS, whether it be news items, feeds for the latest articles in tens of cancer and science journals, blogs from a variety of sources, rss alerts by topic or keyword etc. Keeping track of this huge volume of information used to be unwieldy. 

2. My 6 Sense

One tool I really love and have been using for a while is My 6 Sense.  This cool app takes all the rss feeds from my Google Reader, which is clumsy and awkward to read, and processes them into a more manageable fashion.  

Several times a day I can check the app on my iPhone and see what's new or relevant.  Over time the app algorithms learn what your particular interests are and creates a page of what it considers to be useful items of interest in your RSS feeds via the Relevance tab or as they come in (the Time tab) as shown below (left photo).  

Data is social, though; it cries out to be shared with others. The M6S app allows you to add social media sites such as Twitter, Facebook etc and share any interesting items with your friends or colleagues too. Here, you can also see the items from my shared stream (right photo) as an example of what I found interesting and streamed to others to read:

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Over time, as you use the app more, it gets much better at predicting what you like or may find interesting. One thing I miss from the M6S app is a Search button - what happens if I want to find a bunch of interesting articles in my RSS database on a given topic, eg PI3K or something similar? At the moment, there's no obvious way to do that as far as I can tell, but it would certainly be really useful to me.

3. SimpleNote

I confess that after years of losing data unexpectedly, I've become a bot of a plain text geek. On my Macs, TextEdit was something I use daily, especially when taking notes from market research interviews on the fly. Then one day, someone mentioned SimpleNote, which is a beautifully simple yet flexible tool for gathering text notes.

For some months now, I've been using the App on my iPhone, which allows me to jot down ideas, tasks, notes to self etc on the fly... essentially simple notes.

Then recently, I realised that the free iPhone app also gave me access to the desktop app, which opens up a whole new world of utility and practicality.  Here was something that could help me do multiple things efficiently:

• Research and find interesting journal articles or news about say, PI3-kinase in My 6 Sense
• Email article links to self via iPhone
• On desktop, cut/paste multiple snippets of information to SimpleNote
• Search SimpleNote for older articles
• Write blog post in SimpleNote
• Cut/paste blog post to TypePad for posting
• Sync selected information with DropBox and read from any computer later

Take a look at the snapshot below for the basic SimpleNote concept:

You can see how neat and intuitive this is at first glance and how easy it is to find information, whether it be data or contact information or even the reference link months after clipping it by scrolling down in an individual note:

The DOI is really useful because when I blog about journal articles, I only have to cut/paste the DOI into the Research Blogging site and it generates a nifty bit of code that provides easy access to the article via a link for anyone interested in it.

Over time, I diligently put in tonnes of stuff into these tools, whether Evernote or SimpleNote and they come in very handy for research for blog posts and consulting reports. Essentially, I find that I tend to use Evernote for web clipping and SimpleNote for text processing.

Of course, the short answer to the blogging question is you either get more efficient and smarter at gathering, processing, analysing and generating insights or you work longer hours.  Being a good European, I'd rather work smarter and hope that people appreciate the insights generated either in the blog posts here or in client report :-).

What are your favourite tools and apps that make a difference to your daily workflow?

Managing Multiple Myeloma: turning an acute cancer into a chronic disease

The other day while travelling home on a long train journey, I was browsing the NY Times app on my iPhone and came across an interesting story about multiple myeloma in the Health section:

"For many patients with cancers like chronic lymphoma, chronic myelocytic leukemia and now multiple myeloma, longevity lies in the ability of science to remain one step ahead of the malignancy by unraveling its genetic and molecular underpinnings and producing treatments tailored to counter them."

Now, I don't think there is actually something called chronic lymphoma (non-Hodgkins lymphoma (NHL), chronic lymphocytic leukemia (CLL) and chronic myeloid leukemia (CML), yes), but you get the gist of what the reporter is saying - acute deadly hematologic cancers are gradually being turned into chronic diseases.  

The main reasons behind this are several fold:

1. Greater understanding of the science and biology underlying the diseases.
2. Increased number of available therapies that can be sequenced, prolonging overall survival.
3. Move from chemotherapy to more targeted therapies, improving quality of life.
4. Active drug pipeline in myeloma across several companies, offering increased hope for further advancements in the disease as new combinations evolve.
5. Updating of treatment guidelines and new standards (e.g. see this Myeloma example)

In addition, the growth of Myeloma support groups has provided a wealth of online information, practical advice, and emotional support for people suffering with the disease. Some great resources include:

1. Multiple Myeloma Research Foundation (run by an incredible myeloma survivor, Kathy Giusti)
2. International Myeloma Foundation
3. Leukemia and Lymphoma Society
4. National Organisation of Rare Diseases
5. American Cancer Society

In addition, Pharma companies such as Millennium, Celgene and Onyx/Proteolix are also doing their bit to improve research and outcomes in multiple myeloma in R&D, and some provide people with balanced and fair disease information - not everything has to be promotional.  One such example is an unbranded site about Myeloma supported by Millennium-Takeda, the manufacturers of bortezomib (Velcade) called My Multiple Myeloma.  Velcade is a proteasome inhibitor that has become the cornerstone of front-line therapy either without or before a stem cell transplant.

Now, let's take a look at the My Multiple Myeloma website. I should disclose here that the agency who are responsible for building the site are a client, although I wasn't involved in the website project itself.  I've long had an interest in unbranded sites and disease information from my marketing days, so let's look at what's available at the moment.  

The opening site page offers some sensible choices with clear navigation encouraging people to take charge of their disease and some shots of real people who are experiencing multiple myeloma, you can click through and read more about their stories and experiences:

One of the things that many people forget is that cancer is a complex disease, not only in terms of treatment options, but all the other factors that need to be considered.  Googling for information can be overwhelming and none of the current advocacy sites offer a one-stop shop for everything.  The site looks to reduce this overload and provide a central starting repository for information.  Further into My Multiple Myeloma, you can find some other interesting and relevant information such as coping with the disease, working with the health care professionals involved, costs and insurance, understanding emotions, lifestyle advice, and where to find clinical trials for example:

It will be interesting to see how the site evolves over time and hopefully adds useful tools to allow people to engage and share information with each other.  Providing relevant information is a good start, albeit a static one, but allowing interactivity and sharing of ideas will help bond those affected even more.  

It would be cool to add other practical things such as a wiki for transplant centers, contacts, and other academic centers specialising in the treatment of myeloma, for example.  That way, people can find a hospital near them, or even a means of finding local support groups perhaps.

In the past, I have seen significant value in watching patients converse, help and support each other in disease forums because many-to-many is so much more powerful and effective than an isolated n of 1. People need to feel that they are not alone in their fight against cancer, having a sense of support and community really does help mobilise heart and desire to beat the disease. 

It always annoys me when people think Pharma companies are only interested in promotional or DTC programs that make money or add ROI; in oncology and hematology, I've yet to meet someone from the industry who didn't care about people, improving survival and outcomes or making a difference to people's lives. 

Maybe cancer is just a different world... after all, we have very few placebo controlled trials in this arena; new therapies and combinations typically go head to head against the standard of care in a survival of the fittest approach.  May the best ones win and make a difference, which is great news for people suffering from any cancer.  

Hope is one thing, but improved outcomes and information are even better.

Kumar, S., Mikhael, J., Buadi, F., Dingli, D., Dispenzieri, A., Fonseca, R., Gertz, M., Greipp, P., Hayman, S., Kyle, R., Lacy, M., Lust, J., Reeder, C., Roy, V., Russell, S., Short, K., Stewart, A., Witzig, T., Zeldenrust, S., Dalton, R., Rajkumar, S., & Bergsagel, P. (2009). Management of Newly Diagnosed Symptomatic Multiple Myeloma: updated Mayo Stratification of Myeloma and Risk-Adapted Therapy (mSMART) Consensus Guidelines Mayo Clinic Proceedings, 84 (12), 1095-1110 DOI: 10.4065/mcp.2009.0603

Are you a crazy deranged fool (CDF)?

The other week someone asked me why I do so much work specialising in oncology and cancer, which admittedly can sometimes bring more sad news than good.  

I answered simply: "because I'm a crazy deranged fool!"

Source: Hugh
 

I follow Hugh MacLeod's cartoons daily and also subscribe to his excellent newsletter.  On bad days he keeps me sane, on good days I laugh out loud.

What on earth is a 'crazy deranged fool' you may be wondering?

According to Hugh:

"A CDF is my term for somebody like me, i.e. somebody who actually has the temerity to TRY to do what he loves for a living, as opposed to shlepping for his daily crust."

Running a consulting business and going to many scientific and cancer meetings has it's benefits - one of them is realising you're getting paid for doing something you love and have a lot of enthusiasm for.

Making sense of data is fun; finding patterns and trends amongst a mass of information on a huge variety of different cancers is sometimes like unravelling DNA.

Are you a crazy deranged fool?

Why do some Pharma companies do well in oncology and other's don't?

A chance email yesterday from Matthew Herper of Forbes Health got me thinking.  He was interested in whether a company, who have been successful in other therapeutic areas, could do well in cancer.

A question like that can quietly sit in the back of your mind for days percolating and brewing until you sit down and really think about it.

I've had some great opportunities to work in several different therapy areas including cardiovascular, dermatology, immunology, CNS, hematology and oncology.  The last two have much in common, the others less so.  But what makes them different, what factors are important to take into consideration and how do make it work?

Two of the big differences are data and science.

Cancer is much more technically complex than many diseases and the understanding of how the biochemistry and the drug interact can make or break a product.  One of the first oncologists I ever met, a dour academic chap who did a lot of leukemia transplants and research in equal measure, memorably advised me in a most stern manner to "forget the fluff and puff, just show me the data!"  

Cardiologists and dermatologists always seemed to ask 'how' questions... how much does this cost, how soon will you have slides for a lecture series, how many papers do you have published so far etc.

Oncologists are a different breed.  They ask a lot of why and where questions... why should I use this drug, where is the evidence to show X or Y etc.

For me, it's about learning a completely different mindset and adjusting to a new customer focus.  If your drug isn't better than what an oncologist has already, especially in efficacy, no amount of hype is going to give you a hook or an advantage.  Risk-benefit trade-offs in a serious disease that may lead to deaths forces people to think about the treatments in another light. 

Think about it, the most common questions an oncologist is going to hear from people who visit are:

1. Will I be cured?
2. Will it make me live a little longer?
3. Will the treatment make me feel better?

Intuitively, people with cancer focus on the most important things and for doctors hearing that many times during the course of a week, they will subconsciously be thinking that way too.

Going back to Matt's broad question, I was thinking about all these things yesterday while interviewing an oncologist about how he treats a certain cancer, which in rare cases is curative but in most situations 2) and 3) more clearly applied.  My focus was a little sharper than usual because I found myself automatically asking why questions about a range of different regimens.    

Now, some of the companies for the treatments he mentioned have indulged in typical marketing hype, with fancy programs, e-details and branded campaigns that could well have applied to an anti-hypertensive or skin cream.  As the doctor walked through his treatment algorithm, I could almost imagine the critical survival charts on the wall in from of my desk.  Finally, it became clear that he ranked them by the survival curves, with one exception that was reserved for a small, rare subset that had aggressive disease because the consequences of managing the concomittant myelosuppression were too high. 

And there in is the rub.

Success in the oncology arena boils down to data and how well you stack up against the competition. Being first to market gives you a huge advantage too, since a hurdle is set and the ones afterwards are forced to demonstrate why they are better.

This is way many good marketers I've met avoid or dislike oncology: it's data driven, not marketing driven.

In oncology new products, the best thing you can do is focus on the data and find areas or niches where you can do well. It requires a more analytical approach to understand the science, work with the clinical and research teams and patiently build a blockbuster niche by niche.  If a drug fails in an indication, either find another one quick or ditch it.  Spend money wisely on more smaller phase I and II studies experimenting with different tumour types to match the biology of the disease with the drug's target. This is critical, but it also takes money and time with a high risk attached to it because more drugs fail than succeed.

Of course, once you get a drug to market, that's not the end.  You have to practice 'kaizen' and continually invest more dollars in new indications.  If you're too slow doing this, the second to market drug can be equivalent but have the advantage of a broader clinical program while you sat on your laurels for several years.  Life cycle management means planning ahead for the second and third indications before you finish the first cancer type.  If the first one fails, this also means you have a backup in advanced stages and that's a smarter strategy than everyone trying to get senior management's attention for resources and dollars if you put all your eggs in one basket.

Not every company has the scientific mindset and willingness to invest research dollars to succeed in cancer.  Management by consensus doesn't work very well either, that just drags things down to the lowest (and often slowest) common denominator.  You need passionate driven product champions who fight to the end and generate resources, focus and high priorities to get things moving by corralling the collective energy to get things moving at pace faster than the proverbial snail.

With regards to cancer pipelines, Roche/Genentech and Novartis probably have two of the most promising at the moment and are significantly ahead of the pack in my view.  They invest heavily in science and research, as well as broad clinical programs that creates a continuous buzz. The mindset is clearly to accept a few negatives that are easily over shadowed by the many successes. This creates a groundswell and positive energy.  Pfizer, Merck and BMS all have interesting pipelines, but also have to fight the internal entropy for execution as well.  

Data matters.  Execution matters.

Forget the hype in oncology and think about making a real difference to the lives of people with cancer and intelligent ideas around the concept of artisanal marketing, which my buddy Morgan Brown described in an intelligent and thought provoking post this week:

"Thoughtful, insightful, honest, embracing complexity and celebrating the craft of the product or products themselves."

New search tools for science and disease information

Recently, I've noticed a few hits to this blog from Liquida, so curiousity got the better of me and this lead to research about what it was all about.

Turned out Liquida is a nifty search engine for looking up topics on blogs eg about science, cancer, just about anything you might be interested in:

 

Google search can be frustrating in that it often returns old posts from several years ago before more recent information unless you use the Options button to specify the date range or a more recent period.

Liquida presents the most recent information in a more user friendly, attractive and graphical fashion than merely pages and pages of links that you see on Google and have no idea what is relevant until you click through.

What I also liked about the site is that it offers the opportunity to insert a widget on your blog based on search terms that you might be interested in, such as Cancer or HIV or Diabetes, for example:

Another useful blog search tool that I find very helpful for finding disease information, especially blogs by patients about their disease or condition is Surchur.  It aggregates social information around news, blogs, videos, pictures etc like this:

I used 'Glioblastoma' at random for both searches so that you can see the similarities and differences.  Surchur also has nifty social features so you can vote things up or down, if you feel so inclined.

While everyone else is getting buzzed about Buzz, I'm fascinated with new ways to find insights and intelligence from patients about their treatments and how they manage side effects.  Finding that on Google these days is like wading through treacle by comparison, even with the distracting sponsored ads turned off in my profile:

A patient guide from 2005?  Oh really.  Clicking on the item and scrolling to the bottom tells us that it was actually written in 1999.  Ouch, so much has happened since then and this is why I'm using Google less and less these days - I want more recent, more relevant and more useful information.  While some of the more modern tools aren't perfect, they at least attempt to organise the data in tabs and topics by clickable links to help you sort out the chaff from the wheat.

If you want to search Google for photos, blogs, or videos you have to do a search for each one, making the whole process time consuming and frustrating.  Here's what you get from a blog search on Glioblastoma (all of these tests were done within minutes of each other):

As you can see, it's all a bit heavy compared to Liquida and Surchur.  Try them out for yourselves on topics that interest you and compare them to Google.  If I were a patient or caregiver, I would certainly give the new search tools a try.

What new tools so you recommend for medical information search and why?

Drive: The surprising truth about what motivates us...

Last night and was chilling out and reading Dan Pink's new book about motivation in business, Drive (not an affiliate link), which arrived at my Post Office box yesterday. Excited, I didn't waste anytime digging the car out from the ice pile and dashing off to collect it! 

Here's a quick synopsis from a TED talk that the author gave last summer:

Pink looked at research in motivation and realised that things were skewiff, in other words, most companies and businesses try to motivate people extrinsically using money, bonuses, perks etc.  

However, scientific research shows that people are more intrinsically motivated than first thought and the carrot and stick approach may actually have a detrimental effect.

Interestingly, Pink found that people have:

"An innate need to direct our own lives, to learn and create new things, and to do better by ourselves and our world."

He went on to summarise this concept as:

1. Autonomy
2. Mastery
3. Purpose

The big question then becomes one of how do you create an environment in which this behaviour can flourish?  

Well, you can see it in enlightened places like Google, where managers can have 20% of their time doing projects of their own volition, unrelated to their work.  Some of these projects even make to the market, benefitting the company and the employees.

In an ideal Utopia, everyone would work in a results only work environment (ROWE) where people don't have schedules, show up when they like and get the work done when they want to, as long as deadlines are met.  

In some ways, this is why I enjoy the life as a management consultant running my own firm so much, precisely because there is more freedom to get things done when I want to.  For example, I prefer writing complex reports in the middle of the night in peace and quiet, free from distractions. It becomes almost a Zen-like experience where clarity of thought is much clearer and sharper.  The output is much better that way and clients seem very happy.  It's hard (but not impossible) to do that while working for a big corporation who expects employees to be in the next day by a certain time.  

Of course, one is also free to read, learn and research things that interest you, excused the tyranny of days driven by interminable meetings, but that is another story!

If you haven't read the book, I would highly recommend it.  It's very different from his previous book I read, A Whole New Mind, but equally enjoyable.  If you have read it, what was your perspective?

Why I read PharmaGossip on Fridays

Because he makes me laugh out loud with posts like this:

No, I'm not going to spoil the fun - go and check out his story here.

PeRSSonalized Pharma

One of my Twitter buddies, Dr Bertalan Mesko (@Berci) has built a superb collection of RSS aggregators, catchily called PeRSSonalized Medicine, on his Webicina site around different medical topics a broad range of topics including diabetes, depression, cancer, psoriasis, nephrology etc. He graduated from medical school last year (while running ScienceRoll and Webicina!) and is now a qualified doctor with a strong interest in genetics as well as research in psoriasis and rheumatoid arthritis.

Here's the full list you can choose from:

 

More recently, he extended this excellent theme and launched his Pharma resource as you can see at the bottom of the above checklist.  Here's the Pharma site in more detail:

As you can see from the screen shot above, it includes medical journals, blogs, news and web 2.0 tools shared via various Pharma bloggers on Twitter; all the content is efficiently organised alphabetically.

Of course, I was delighted to see this humble little blog included, but do check Berci's excellent resource out because it's well worth looking at. You can also follow him on Twitter for more regular updates. The site is free, just sign up and away you go. 

Overall: It is a well executed and nicely curated medical site for physicians and patients alike - great job, Berci!

{Disclosure: This website, Pharma Strategy Blog, is included in the Pharma site I just reviewed and I am therefore undoubtedly biased in reviewing PeRRSonalised Pharma, but please do check it out and see for yourselves what can be achieved with medical information and web 2.0 tools.  If more pharma sponsored sites had half a much independently curated and unbiased information, they would probably do very well.}

Between the Lines - Proto Magazine - Massachusetts General Hospital

By using language- and pattern-analyzing software to search and distill the cascade of words on social networking sites, researchers may be able to identify trends and signals, such as repeated mentions of a certain drug in connection with a particular side effect or treatment success. “Listening” to thousands of patients as they discuss treatments, side effects and experiences with their diseases might even help scientists come up with hypotheses worthy of study. “There’s a tremendous amount that goes on in a patient’s daily life,” says Frank Moss, director of the Massachusetts Institute of Technology Media Lab, an emerging-technologies research group that helped create one disease-related networking site, and a founder of the cancer drug company Infinity Pharmaceuticals. “They’re trying off-label drugs, different diets, different exercise, different lifestyles. That information isn’t easily available to clinicians, but the cure to the disease may lie within it.”

via protomag.com

This is an excerpt from the Massachusetts General Hospital quarterly magazine, Protomag, which you can also read online, via the link above.

The article isn't just about data mining, but also about how patients can connect and converse about their disease through forums as well as the dangers of social media sites that are unchecked by authorities (viz the FDA).

The 'deep web' as Gilles Frydman described it in the comments to the recent post on this blog about the FDA, social media and patients, has both advantages and disadvantages. One the one hand, it is a great resource for people needing advice from others with the same condition and on the other, it can be a fertile ground for misinformation and unscientific data with no substance or rigour.

Check out the full article in Protomag, it's well worth reading.

Posted via web from sally church's posterous

Friday afternoon fun

Recently, I was talking with a client about how we use social media for competitive intelligence gathering and the importance of aggregating RSS feeds from blogs, alerts, newswires and journals etc to create a living database that can be searched for useful information.  The data gathered can be used for market surveillance and landscape opportunity assessments.  I showed them some snippets based on their area of interest and thankfully, it produced some useful information they didn't know.  They seemed suitably impressed.

As the conversation continued, we discussed the value of continuous learning and how we get smarter by reading great blogs from other people.  Then I got floored with a neat question; "which blogs do you actually read every day and enjoy?"

This brings me to the topic of this weeks Friday afternoon fun - putting other people in spotlight.

Although I aggregate a lot of feeds, I don't actually read them all and instead use them for search purposes.  On my Mac Mail, however, is a nifty feature that allows me to import RSS feeds of blogs I enjoy reading daily, like this:

As new blogs are posted, a number to the right indicates how many are unread.  This makes it easier to track new posts.

I also use the Notes feature above the RSS to jot quick thoughts and ideas to myself around things I find interesting.  These are synced with my iPhone and important topics I also email to my Evernote database partly as a backup and partly because I also use its awesome search features in conjunction with the RSS search.

So, what do I read daily?  An eclectic mix from science, medicine, tech, finance, economics, food and of course, pharma and biotech.  This list is continually refined with new ones added and old ones deleted.  For me, though, they're interesting and thoughtful people and I learn a lot from smarter people who take the time to think and write about a wide range of things.

Check them out, you may find some new ones you like too.

How to find Icarus Consultants on the internet

Last week a client left a message asking me how they could find me online as they had misplaced my email address and our website is pointing to this blog while we upgrade the shop window.  It was tempting to leave a message saying "Google it" but instead it gave me food for thought.

For starters, like many, I'm around on all sorts of social media and science sites as well as professional business ones too. 

Here's a small selection, for example:

   

In addition, we also have a number of blogs other than this one, which have just restarted after an extended hiatus due to pressures of work (hey, it's always nice to be seriously in demand) on the following topics:

Pharma Market Strategy

Market Trends

Technology and Insights

Hematology Market Insights

Competitive Intelligence

They will all be getting fresh new looks soon, along with our website, so watch this space as Icarus Consultants is going places!!

Icarus Consultants website

Our website has been redirected to this blog for now while we change servers and the window displays (read attractive new content and information).

Normal service will be resumed as soon as we have the time to write the copy and do the redesign.

Listening to patients is the most important thing in Pharma Marketing

Yes, that's right; patients.  Not doctors, nurses, pharmacists, payers or other HCP's, but patients.

Patients are the people taking the therapies, educating themselves, their families and other sufferers about the disease, and quite frankly, often the marketing people responsible for the commercialisation of drugs.  They can make or break your brand as promoters or detractors without you even knowing it, so my advice to Pharma marketers is ignore them at your peril.

This applies to depression, hypertension, cancer, asthma, or just about any disease there is.  The silent voice has real power.  How many Pharma marketers actually routinely listen or monitor patients though?  Some might do it once a year, but really, my opinion of those nebulous and expensive focus groups favoured by market research companies cannot be printed here.  The samples are prone to bias and desperation by the recruiters anxious to fill the slots and anyway, how on earth is 20-30 patients representative of a disease universe?  The answer is, it isn't nor is it even directional.

One of the coolest things ever invented surely was the internet.  I doubt if Tim Berners-Lee ever imagined the sheer power of information that might even be possible with search engines.  Patients blog, they chat in forums, they communicate in multiple ways.  All of this activity can be a gold mine if you know where to look and how to influence them.  Feedback of course, goes both ways - learn to listen, take your lumps on the chin, improve and make things the best you possibly can given the time and resources you have available.  Life is not a game of perfect, it's about doing what matters and caring about the patients.

Take a look at this site, for example.  Jerry Mayfield is a quite simply a great guy.  A former Louisiana State Trooper, he created a wonderful website in his own time and money after being diagnosed with CML.  He regularly added new links to relevant resources and physicians for other fellow sufferers of the disease and a whole cottage industry sprang up around the buzz relating to the Gleevec CML trials way back in 1999-2000.  I know, because as one of the marketers, we followed their progress avidly and were humbled, excited and saddened along the way.  I am pleased to see that the concept has expanded and now new 'Talks' exist for other new therapies in this area, enabling patients to ask questions, share their experiences and generally provide virtual support for each other. 

From a company perspective, the information was incredibly useful as we followed their lives remotely, working on ways to improve things whether it be to push the company to make more drug or speed up the development.  The power of a strong patient group can really help your case.  They can also tell you about their needs, their goals, their side effects and how well different dosages are working; critical information you could never hope to get in a focus group.  It helps you plan ahead, working with key opinion leaders and the medical team to publish papers on practical side effect management, for example.  These days, web2.0 and social media monitoring make computerisation and tracking of these sentiments so much easier and quicker compared to 10 years ago and the days of manually reading through hundreds of postings around cyberspace.  I ardently wish I had the tools of today available then.

It's been a while since I checked out the patient groups as time and my role has moved on but today I popped back to look at Jerry's site while wondering how how he and several others were doing.  After all, before Gleevec, CML patients typically lived 2-4 years and it's now 11 years since the first patient first visit back in 1998.  Partly, I was hoping for a minor miracle that perhaps our dream of helping CML patients live to 10 years would be realised.  Nervously, I clicked through and found a wonderful posting on the first page of the Gleevec talk posted earlier this month:

"I was dx 1/01 and it took 3-4 years and Gleevec at 800mg to get my bcr 0.000 (up/down a little, last test 0.004). I learned from this site how to be proactive in your healthcare. If it wasn't for this site I'd probably be dead by now. I had to tell my doctor when he needed to increase my dose. He became confident in me because of the knowledge I expressed about CML and Gleevev. Because it was very rewarding to be able to learn more about my condition and then work WITH my doctor in my treatment, I decided to go back to college to be a nurse. I'm 47 yrs old and in three weeks will be graduating with my Bachelors degree in Nursing. This is why I haven't had time to really follow the site and post. It has been very rewarding (and very difficult) and if I would never have been dx with CML I probably would not have done this. At times I almost forget that I have CML. The side effects of Gleevec are just a part of my life now. I just would like to encourage everyone to not give up your future goals just because you have CML, live it to the fullest, and DEFINATELY be proactive in your health and healthcare."

Wow.  That's far better than I might even have hoped for after meeting the doctors involved in the phase I clinical trial way back in September 1999.  This is true patient power  and promotion helping educate her own physician become more confident, willingly sharing knowledge with others and getting on with her life despite a life threatening disease.  This is stuff dreams are made of.  It gives me goose pimples thinking about turning even one cancer into a chronic disease like diabetes.

Image via Wikipedia

The early Gleevec team was relatively small, but close knit one.  A bunch of hard working committed individuals dedicated to doing it's best for patients from all areas of the organisation, whether it be R&D, commercial, manufacturing or whatever.  Not everything in the drug industry is bad no matter what you read in the papers.  It sounds corny except that it's true; a great bunch of people I wouldn't hesitate to work with again and time I saluted and thanked them publicly for all their hard work and effort under tremendous pressure.  Whenever the team got stuck on an issue, someone would chime in, "What's the right thing to do for the patients?" and the problem would somehow get solved.

The management was pretty good too - very supportive and encouraging at every step of the way without interfering or micromanaging.  You couldn't ask for more.  We were also lucky to have some great partners in the agencies and third party companies we worked with.  The physicians in the phase I and II trials were some of the best and brightest I've ever worked with, but what made them stand out was they really cared about their patients welfare. 

The whole process became like a relay race with the baton being passed around from one team to another as the product moved inexorably towards market approval.  For everyone who worked on the STI571/Gleevec development it ceased to become a job per se, instead it became an honour to participate in whatever small way to making a difference to patients lives.  The most powerful thing you can listen to is their stories, about their fears, their struggles, their hope and ultimately, overcoming the obstacles.  I have yet to hear one that didn't make me cry or be sensitive to the moment.

Real teamwork starts with the right people.  Every once in a while we all get a chance to be part of something truly incredible.  And it starts with putting the patients first.  Do that and the rest will follow.

This post is dedicated to the brave patients who willingly took part in the Gleevec trials, the leukemia physicians who ran them and my team mates who did everything possible to making a real breakthrough in cancer treatment happen.  I salute them all.

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Thinking and focusing on the BIG picture

Alan Webber in his book Rules of Thumb came up with a startling rule that made me sit up and pay attention.  In it he essentially said keep two lists:

• One that holds what gets you up in the morning
• One for what keeps you up at night.

"Managers and leaders have got to know themselves before they know their businesses. They've got to have passion for their work and concern for their world. Otherwise they're just punching the time clock and risking everyone's future."

That made me think and focus. 

I love what I do, getting up in the morning is rarely a problem and enjoy working with a lot of fun people in the Pharma and Biotech industry on cool and interesting projects.

Quieting my brain and getting to sleep is another matter entirely.  With the economy in the tank, I worry about my mother as she slips into the twilight of her life with the accompanying physical deterioration, my little brother who is finding business very hard right now and friends who are less fortunate and have been laid off.  Some 50,000 jobs have been lost in the Pharma industry alone over the last 18 months, leaving fewer, more stressed people doing yet more work.

Image by Getty Images via Daylife

I try to stay positive, but it isn't always possible. 

And then you hear the tragic news that Phil Mickelson's young wife, Amy, has been diagnosed with breast cancer.  That puts things into perspective and my thoughts are with her and husband who has just left the PGA tour.

What about you?