Guys in Bras

Would you pay to see a guy in a bra?

What if it was a strapping linebacker modeling the abovementioned undergarment, complete with blinking lights, and other assorted bling?

If you live in Detroit, in exchange for a donation, your chance to see not just one, but 20 or so athletes and future army officers in bras is coming soon.

Every year, since 2004, the student chapter of the Society of Intellectual Sisters at Michigan Technological University puts on its annual guys-in-a-bra fashion show to raise funds for the National Breast Cancer Research Foundation.

The event also features a speech by a breast cancer survivor and an auction of the hand-decorated bras sported by members of the football team, Reserve Officer Training Corps (ROTC) and the Society of African American Men.

“It’s fun to watch the guys strut their stuff,” says organizer Lydia Brame.  Last spring, the theme was candy; next spring it will be Las Vegas. Expect bras decorated with dice, chips and roulette wheels.

For all the fun, the Bra Show is serious stuff. “Support the cause,” the Michigan Tech women say. “Uplift the world, a woman at a time.”

SRxA’s Word on Health thinks this is a great idea and one that could be adopted by colleges all over the country. Would you be man enough to step up to the challenge?

Drug Reps Set to Become Slaves to Their iPads

In recent weeks SRxA’s Word on Health has run a number of stories about iPads.  For the record, we don’t have shares in Apple, nor do we even have iPads, though we’re keeping our fingers crossed that Father Christmas might bring us one this year.   This latest iPad related post is particularly interesting as it could potentially change the pharmaceutical industry forever.

Last week, GlaxoSmithKline (GSK) sales reps were handed a lesson in “be careful what you wish for.”  If they win their ongoing U.S. Supreme Court appeal over overtime pay, their employers may well make them slaves to their iPads by introducing factory worker style rules for clocking in and out.

For our readers unfamiliar with the case, hundreds of GSK ’s pharmaceutical sales reps signed on to a class action lawsuit demanding overtime pay. The suit  was filed in 2006 by lead plaintiff Anthony Coultrip, who worked for GSK between 2003 and 2005 and hinges on a counter-intuitive definition of what a sales rep actually is. Under federal labor law, salespersons who earn commissions are exempt from protections requiring overtime pay for extra hours worked. Drug reps, however, don’t actually “sell” drugs – they merely promote them and the sale occurs later at the pharmacy. The GSK reps argue that makes them “promotion workers” whose work is so routine that they ought to get overtime.

Anyway…back to the story. If the Supreme Court rules in favor of Mr Coultrip and his colleagues, and institutes overtime pay, life for the nation’s 90,000 drug reps could change dramatically.  Instead of the relative independence and limited accountability that they enjoy today, the life of a pharma sales rep could become a nightmare  of check-ins, surveillance, time-sheets and electronic monitoring.

Hardly surprising given that a huge sum of money is at stake here.  Since the litigation began, at least 19 pharmaceutical companies have been sued by sales reps demanding overtime pay.

To try to minimize overtime payment liability, industry analysts predict that clocking in and out of work via an iPad will soon become the most important act of a rep’s day. Failure to clock in and out may result in loss of pay for that period of time.  Repeatedly “forgetting to clock in or out” may result in disciplinary action including the possibility of termination.

Taking this to extremes, industry insiders predict a scenario in which:

  • Reps will be GPS tracked to verify time and location for all work related time during the work day.
  • The same tracking will also be used to verify mileage for business versus personal use of the company car.
  • Any rep planning to take more than two hours of personal time during a workday may have to get prior approval for a vacation day.
  • Drug reps work will not be allowed to work more than 8 hours per day or more than 40 hours per week without prior written approval from their manager.
  • If reps receive emergency customer calls, outside of their work day hours, they will have to adjust subsequent work time so as not to exceed the 40 hours per week maximum.
  • They will be required to clock out and back in for their mandatory 15 minute breaks, in the morning and afternoon.  They will not be allowed to skip breaks or to do work related activities during breaks.
  • Because all work related travel time will count against the 8 hour work day, most company meetings will be by tele- or video-conference to avoid travel.

However, not all  reps believe they deserve overtime. On cafepharma , the anonymous bulletin board for drug industry gossip, some have suggested that reps don’t work the hours they are meant to work, let alone qualify for overtime.

What’s better?  Is overtime pay worth the loss of freedom and Draconian restrictions?  As always, we’d love to hear from you.

Falling for Pumpkins

Here in the nation’s capital, the cooler temperatures and brilliant colors of Fall are upon us. Pumpkin patches are opening everywhere and among the neighborhood kids, the countdown to Halloween has begun. This year, rather than throwing out the pumpkin seeds after carving lanterns or making pie, nutritionists are suggesting that we eat them. Pumpkin and its seeds provide many nutritional benefits including:

  • Protein: pumpkin seeds are high in protein
  • Essential fatty acid oils: to help maintain healthy blood vessels, nerves, tissues and hair

 Snack on a quarter-cup of pumpkin seeds and you will receive 46% of the daily value for magnesium, 29% for iron, 52% for manganese, 24% for copper, 16.9% for protein, and 17% for zinc.

It’s claimed that pumpkins can also support kidney, bladder and prostate health; minimize osteoporosis, help get rid of parasites & tapeworms, and lower cholesterol due to the high levels of phytosterol.  Pumpkin seeds may also alleviate symptoms of depression as they contain L-tryptophan.

Dr. Helen Lee of recommends four ways to incorporate pumpkin into your everyday diet.

  1.  A handful of raw pumpkin seeds as a snack or mixed with trail mix, on top of cereal
  2. Pumpkin seed butter spread on toast
  3. Pumpkin pie/desserts/pancakes/waffles
  4. Pumpkin baked or browned with spices in risotto, chili, rice, spaghetti

SRxA‘s Word on Health’s personal favorite is pumpkin seed oil, a wonderful thick, green- oil that is produced from roasted pumpkin seeds. Try it drizzled on pumpkin soup or mixed with balsamic on salads. If you’re feeling adventurous you can even do as the Viennese, and add a few drops on vanilla ice cream.

Go on, share your favorite pumpkin recipe with us!

Game Set and Match Sjögrens

Earlier this year, we brought you news of Serena William’s  health scare after she was diagnosed with pulmonary embolism. Serena has since made a successful comeback to pro tennis, winning 18 straight matches between July and September, including titles at Stanford and Toronto, and becoming a finalist in the US Open. However, by some strange, sad twist of fate, her sister, Venus Williams, was forced to withdraw from the same tournament after being diagnosed with Sjögren’s syndrome.

Sjögren’s – a condition in which the body’s immune system attacks its own healthy tissues. It primarily affects glandular tissues – most notably the tear and saliva glands. It can result in dry eyes and a dry mouth. In addition, patients can experience muscle and joint aches and pains, as well as debilitating fatigue.

While a combination of genetic and environmental factors can lead to Sjögren’s, as with many autoimmune diseases, the onset of the condition is often preceded by an infection. It’s understandable how these symptoms might make it difficult, if not impossible, to play tennis at a high level.

I think I’ve had issues with Sjögren’s for a while. It just wasn’t diagnosed,” Williams told ABC News. “The good news for me is now I know what’s happening.”

While Sjogren’s has no cure, there are treatments that make symptoms more manageable. In addition to over the counter (OTC) eye drops and mouth preparations, prescription products are available. They include Evoxac® (cevimeline), Salagen® (pilocarpine hydrochloride) and Numoisyn™ for dry mouth and Restasis® (cyclosporine ophthalmic emulsion) and Lacrisert® (hydroxypropyl cellulose ophthalmic insert) for dry eye. Additionally, anti-inflammatory drugs can reduce joint and muscle inflammation; and certain drugs can help to either suppress or modulate the overactive immune response.

Let’s hope Venus can recover as fast as her sister and that we can look forward to a 9th grand slam finals between the pair.

Joint Treatment for Asthma?

Once again, Word on Health brings you news of a potential breakthrough in the treatment of asthma.  Researchers in Australia believe that a drug used to treat rheumatoid arthritis could also help patients with asthma. According to a paper published in the Lancet the scientists from Down Under have identified two mutant genes that may predispose a person to asthma. After comparing 58,000 DNA samples of people living in Australia, Europe and the United States they found two regions of the DNA that are consistently different between asthmatics and non-asthmatics.”  One of the genes is also linked to rheumatoid arthritis (RA) and the researchers suggested that the drug tocilizumab, which is used to treat RA, may also work for asthma. Tocilizumab, marketed under the brand Actemra by Genentech, targets a certain molecule in the body called “interleukin-6 receptor” and reduces inflammation in RA patients. “Targeting interleukin-6 receptor may be a good strategy to reduce or prevent inflammation (in asthma) in the same way that it is used to prevent or reduce inflammation in rheumatoid arthritis,” suggests lead author Manuel Ferreira at the Queensland Institute of Medical Research. Word on Health awaits further research to confirm if and how the drug may help asthma patients. We’ll bring you further news as we hear it.

iPads replace books at Weill Cornell

A month ago SRxA’s Word on Health reported that most doctors are not impressed with iPad wielding pharma reps.  However, it seems, this may be set to change.

Starting this fall, all first and second-year students at Weill Cornell Medical College will be provided with a new iPad 2 in place of the printed course notes and texts used by most students around the country.

With a  wealth of medical information and educational tools at their fingertips Cornell medical students will now be able to download course materials, see video or hear audio recordings of lectures, submit electronic course evaluations, access their grades, collaborate with other students, and save their notes and coursework.

I am very proud that Weill Cornell is one of the first medical colleges in the country to embrace this technology,” says Dr. Carol Storey-Johnson, senior associate dean of education at Weill Cornell Medical College. “The iPad will open a world of new learning opportunities for students and dramatically expand the way we train and educate a new generation of physicians.”

According to Jason Korenkiewicz, assistant dean of education administration, the paperless iPad is also a green alternative, that will save approximately 2 million pages and copies without being any more expensive.

Students are giving the device high marks. Although some were apprehensive about how the iPad would fit into their learning model, the response has been extremely positive and quickly won over the students who were resistant to changing their study habits.  Not only do they avoid lugging around heavy printed text books, they have found that the iPad reinforces learning and retention of information through a variety of multimedia.

For example an app called “Unbound Medicine” is a medical database for diseases, medications and diagnoses. Such reference applications give students the ability to have the most up-to-date medical facts and findings with them at all times.

Additionally, students can use interactive apps on their iPads to see animated 3-D molecular models of different proteins and compounds. The device’s advanced graphics allow students to view molecular structures with depth, rather than as a flat illustration on a sheet of paper, helping them to better understand how the structures function in the body.

The devices will also help students prepare to be clinicians in the electronic age. Going forward, there are plans to have students’ iPads synched with electronic medical record systems for training during their internships.

We’re guessing that this new generation of doctors will have fewer problems seeing pharma reps with iPads.  Maybe in the future we’ll all be seeing i-to-i.

What Women Want…

…aside from a great body, a good man and killer shoes! Today we’re talking health, and women’s health in particular. We all know that health is the most searched topic on the internet so it’s hardly surprising that approximately 34.5 million women aged 40-59 go online each month.  and that 56% of them say they frequently use online sources of health information.  However, this doesn’t automatically mean they believe what they find. Internet giant Yahoo! and internet marketing experts Digitas Health partnered to thoroughly understand this group of women as people, not just as patients. They interviewed and surveyed thousands of women across America to better understand how they think and feel about their life stage, their health and caring for others with health conditions. According to the results of the  Yahoo!  / Digitas Health survey, just 21% of women aged 40-50 strongly agree with the statement “I trust the health info I find online.” Some other major insights emerged.

  • 66% of midlife women pointed to “no hidden agenda” as one of the attributes they strongly value in online health information
  • 67% said that they strongly value “information that is easy to digest and understand”

Pharmaceutical marketers take note! Women in this age demographic are a critical audience for advertisers based on their tremendous spending power and because roughly 3 out of 4 have at least one health condition. clearly there is room for improvement. “Two-thirds of the women we spoke to strongly agree that they need to understand the pros and cons when making decisions about health,” says Amy Janis, Senior Manager of B2B Market Research for Yahoo!  “It’s not that these women feel that brands have some ‘hidden agenda’; it’s more that they want companies to have ‘her best interests in mind.” It turns out what women want is: factual and prescriptive information that delivers emotional support and confidence to help her feel like she is making the right decisions. So what does this mean for pharmaceutical marketers? According to the study authors,  they need to :

  • Be honest and strong
  • Be everywhere she is
  • Be in the content she cares about
  • Be present emotionally
  • Be specific to health styles

SRxA’s Word on Health believes that given consumers’ cautious attitude toward the health-related material they find online, direct-to-consumer marketers must make transparency a priority in the material they present on the web. It’s time to set aside overt commercial agendas and ensure that the data provided is consistent with the type of unbiased health information they would receive from their healthcare professional. The industry also needs to recognize that patients and consumers are unlikely to base their healthcare decisions based solely on the information provided on one site. As such it makes sense to provide links to other credible health information online and hyperlinks to help people navigate and understand complex medical terminology. Better still, pharmaceutical companies can partner with independent third party specialist healthcare consultancy organizations, such as SRxA, to write credible peer-reviewed copy that talks directly to their target audience. For more information contact us today.

Prescription Drug Vending Machines

Gone are the days when all vending machines sold were sugary or salty snacks, sodas or soggy sandwiches.

In something of a genius move, patients attending Blue Island Illinois’, MetroSouth Medical Center’s emergency department can fill their prescriptions before they even leave the hospital.  No more driving around searching for an open drug store in the middle of the night.  That’s because the hospital is the first in the state to install InstyMeds, a 24-hour vending machine which immediately dispenses most medications prescribed for emergency room patients.

Like a cross between an ATM and a soda machine, InstyMeds is available for all emergency department and same day surgery patients with commercial insurance who need a prescription filled immediately.  By entering a special code provided by the emergency department physician who has pre-entered the prescription details electronically, InstyMeds dispenses medications such as antibiotics, analgesia, eye drops and allergy medicine, among others.

We really like this program because our patients can go right home after visiting the emergency department, any time of day or night,” explains Dr. Eric Nussbaum, Chairman, MetroSouth Medical Center emergency department.  “Patients love this program because they don’t have to wait in line at the drugstore with a sick child and the prescription is the exact same price.”

Using an easy touch screen, InstyMeds automatically determines each patient’s insurance co-pay and the cost of the prescription then processes the patient’s payment using a credit or debit card.  It even has a built-in telephone and help-line so patients that can ask questions about the medicines they have been prescribed.

No more standing in line at a retail pharmacy. No more forgetting or procrastinating about filling your prescription. This really is medicine where you want it, when you want it.

SRxA’s Word on Health is impressed.  Have you used an Instymed?  Share your experiences with us.

Infection control controls costs

Aside from blogging, SRxA duties, and volunteering as an EMT, once a month I teach infection control to Fire and Rescue personnel.  During classes I stress the importance of the basics – training, hand-washing, good hygiene While most students probably forget the more scientific aspects of my lectures, they all remember the advice “if it’s wet, sticky and it’s not yours, don’t touch it!”

I was therefore interested, but not altogether surprised, to read a new study published in the September 2011 issue of Health Affairs, which showed that simple infection control measures could save thousands of lives and billions of dollars.

According to the U.S. Department of Health and Human Services at any given time, one of every 20 hospital patients has a hospital-acquired infection. This leads to an estimated 99,000 deaths in the U.S. each year and up to $33 billion in preventable health care costs.

The study, undertaken by researchers at the University of North Carolina at Chapel Hill, tested three interventions aimed at preventing and reducing hospital acquired infections.

The first intervention was strict enforcement of hand hygiene practices. All health care workers were expected to wash their hands with soap and running water or an alcohol-based rub on entering and leaving a patient’s room, before putting on and after removing gloves, and before and after any task that involves touching potentially contaminated surfaces or body fluids.

The second intervention was aimed at preventing ventilator-associated pneumonia and included measures such as elevating the head of the patient’s bed while the patient was on a ventilator, giving the patient daily breaks from sedation to assess whether or not the patient is ready to come off the ventilator, and providing daily oral care (teeth brushing, mouth washes, etc.) with a long-lasting antiseptic.

The final intervention was ensuring compliance with guidelines for the use and maintenance of central-line catheters. Examples included using sponges impregnated with an antiseptic, using catheters impregnated with antibiotics whenever possible, and performing two assessments per day of whether patients with central-line catheters still needed them.

Results showed that patients admitted after these interventions were fully implemented got out of the hospital an average of two days earlier, their hospital stay cost about $12,000 less and the number of patient deaths were reduced by two percentage points.

The costs for implementing these measures were modest – less than $22 / patient/day. However, adoption of the three interventions could potentially save thousands of lives and billions of dollars each year and improve the care of all patients.  Proving once again, it’s sometimes the simple things in life that are the most effective.

A new approach to new drug approvals?

Few topics inspire more heated discussion among drug developers and pharmaceutical industry watchers than the regulation of new products.  For those unfamiliar with the debate, the two sides of the argument can be summarized as follows.

Industry veterans feel that excessively conservative regulators squelch innovation in a desire to cover their own behinds, while industry critics contend that regulators aren’t strict enough, and that pharmaceutical companies should be held to an even higher standard and warrant even greater supervision.

In the meantime, patients wonder why modern science hasn’t produced the medicines they so desperately need.

Now it seems there may be an answer that could satisfy everyone.  Susan Desmond-Hellmann, Chancellor of the University of California, San Francisco (UCSF) and former Genentech executive, suggests turning drug approvals from a discrete yes or no variable into a continuous moving target.

The fundamental problem with the current system, Desmond-Hellmann observes, is that regulators have only two options, when in fact, it might make a lot more sense for them to have a range of choices. She proposes that agencies, such as the FDA, could approve a drug for limited use, or use with limited promotion, following the submission of initial acceptable evidence of safety and efficacy. Permission for broader use, and less restrictive promotion, could be given after additional data are obtained.

This solution appears to make sense on many levels. It acknowledges:

  • the long time it takes to become familiar with a drug and learn some of it’s more subtle effects – good, as well as bad
  • the importance of accelerating the time it takes to get potentially useful drugs into the hands of patients who might need them
  • the technologies now available to track and assess the performance of new drugs

FDA Approval Process

One advantage of such a system would be the emphasis it would place on durable results, as full approval would likely require not just success in a clinical trial, but continued demonstration of success under “real world” conditions.  Such a requirement would almost certainly stimulate the development of integrated “health solutions,” a bundled assortment of patient- and physician-support programs accompanying the drug.

Although a graduated regulatory approval process would not be perfect; it is almost certainly a significant step in the right direction.

Patient and physician educational and adherence programs make sense, but many companies have been reluctant to invest in them.  In the context of an offering that would need to succeed in order for a drug to be fully approved, the incentives are considerably more apparent, and would almost certainly stimulate interest in companies striving to deliver the most effective patient support programs.

However, the big questions still remain.  Are regulators ready for such change? Is the Industry ready to take on the responsibility and cost of ensuring appropriate use of their products and long-term pharmacovigilance? Would patients and consumer watchdog organizations accept a tiered approach?

What do you think?  SRxA’s Word on Health would love to know.