April 2009 Archives

Over the weekend, a swine flu virus, influenza A (H1N1) strain, has appeared in Mexico, the United States of America, Canada, France, Spain and New Zealand.  The World Health Organization (WHO) has stated that the current situation constitutes a public health emergency of international concern, and they have raised their level of influenza surveillance globally. 

At this point, we, as a company, are not activating our full pandemic preparedness plans in Mexico and the US. GSK has implemented the preliminary parts of its plan in Mexico City.  We are reviewing our crisis, continuity, and pandemic preparedness plans across the business to prepare for implementation if needed. 

What you can do:  

Stay calm and informed. The Centers for Disease Control and Prevention (CDC) have posted general information on swine flu. If you develop signs and symptoms of flu (rapid onset of fever, joint and muscle aches, headache, etc), stay home and contact your doctor within 24 hours to determine if treatment is needed.

GSK continues to closely monitor the situation with the WHO and other national agencies, and stands ready to initiate discussions with local authorities for the manufacture of a vaccine to help prevent this new influenza strain, once a suitable candidate vaccine strain is available from the WHO.  

Last week in Orlando, more than 1,000 GSK employees attending a national sales meeting gave 3 hours of their time for one of the largest Orange Day events yet. Orange Day is GSK's day of service that all employees are able to take advantage of. Twenty-one buses shuttled the group to two Orlando locations in need of help.  Half of the team went to a homeless shelter for women and children and the other half went to a large public park.  The volunteer work equaled 3,000 hours provided to the Orlando Community

At the homeless shelter site, volunteers got down and dirty, removing overgrown vegetation, planting gardens, building a playground, painting murals and putting together new picnic tables. 

"When the team pulled up in our buses, we all looked and wondered what we would do with just an open field of sand, trees and debris. In just an hour I was amazed--what a difference you can make in a short period of time when you apply energy to enthusiasm. I am proud to be part of this event and I will definitely look to do more in my own community when I get home," said one volunteer.

The other location was a large public park used by many in the Orlando Community. Each year, Moss Park serves more than 250,000 children. GSK Vaccines volunteers wasted no time in making improvements to the park by: installing sidewalks, removing overgrown vegetation, installing safety guide posts, sanding and painting picnic tables and pavilions, and mulching playgrounds.

GSK worked with a non-profit group called, Hands on Orlando, which helped coordinate the Orange Day event. Hands on Orlando works with dozens of Fortune 500 companies each year.

For information on Hands on Orlando, please visit their website: at www.handsonorlando.org.

You may have heard that an online war was raging this week. A war between kings: Larry King and Ashton "Twitter King" Kutcher. 

Kutcher told King that he could amass 1,000,000 followers on Twitter before CNN could.  He tweeted that if he did, he would donate 10,000 treated bednets to Malaria No More.  Bednets prevent mosquitos--which spread malaria--from infecting people.  It is such a simple way to prevent the disease.

Well, he did. During the run up to the big win (which happened today), Kutcher had been tweeting a great deal about malaria. As a consequence, other celebrities on Twitter have lent their support and are donating bednets:

CNNBrk - 10,000

Ryan Seacrest 10,000

Oprah - 20,000

At GSK we are committed to playing a significant role in improving the health of communities affected by malaria in three ways:

• Through on-going research--we have a new vaccine in development to prevent malaria
• With preferential pricing of our anti-malarials in the least developed countries and sub-Saharan Africa
• Through our community investment activities funded by the GSK African Malaria Partnership, founded in 2001 to improve the prevention and treatment of malaria in sub-Saharan Africa.

Defeating this disease, which kills one million people each year, is no simple feat. It will require both collaboration and creativity, not to mention multiple interventions, like bednets and medical advances.  This week we got to witness an interesting real-time case study of what celebrity and social media can do for the greater good.

Well done, Mr. Kutcher.

This morning's WSJ reports on insurers' struggles to manage healthcare spending through prescription benefits.  The article discusses whether an insurer with an in-house pharmacy benefits management group is better at managing prescription coverage rather than a large independent PBM.

In a related WSJ Health Blog post, Jacob Goldstein writes

Insurers such as Aetna and Cigna argue that by owning their own PBMs, they can more cohesively manage patient benefits. But others have argued that the huge PBM specialists can leverage their size to get better prices from drug makers, lowering cost.

What is troubling about these two articles is that they discuss healthcare costs as discrete line items rather than as interrelated parts of a complicated whole. Even worse, there is no mention of improving the health of the people covered by those plans.  It is as if improving the health of patients is, at best, a separate "work stream" (to use some overused business jargon), and, at worst, an afterthought to lowering prescription spending. 

We can't just impose lower prices or mandate the use of generics and see long-term savings. That is temporary solution.  In fact, there are many examples of employers that have designed benefits for employees (and dependents, if covered in the plan) with certain chronic diseases that actually try to improve prescription adherence by removing barriers (like copays) or incentivizing them (free diabetes supplies or pharmacist coaching), leading to improved health outcomes and lower healthcare spending.  Places like Asheville, NC or the cities in the Diabetes Ten City Challenge,employers such as PPG Industries and coalitions including Lancaster Business Group on Health, have had impressive results in the area of value-based benefit design.

For more information on the combined benefits of creating a healthier workforce and lowering healthcare spending, you can visit GSK's Center for Value-Based Health Management, an online resource for benefits managers, brokers, and others.

The World Health Organizations's World Health Day 2009, which is today, focuses on the safety of health facilities and the readiness of health workers who treat those affected by emergencies. Underscoring the urgency of this message are the real-time efforts of relief workers desperately trying to find and care for survivors of the earthquake in Italy yesterday.  As of 3.49 GMT, there were 207 fatalities, 150 people were rescued, 1,000 were injured, and 17,000 left homeless.

Making the timing of this even more surreal than World Health Day is the fact that many eyes are traditionally on Italy this week--the week before Easter.  Although many Italians--and one could assume tourists--are displaced and injured, and so many historic buildings were ruined or severely damaged, the government has so far said it does not need any foreign aid.

GSK is monitoring the situation to see if and how we can be of assistance.  

Diabetes is a huge problem in the US, both in terms of health and healthcare spending.  For individuals, poorly-managed diabetes can lead to complications such as blindness and limb amputation.  For employers, workers with poorly-managed diabetes often require costlier treatments and miss days of work. 

However, medication adherence is often a challenge for patients with chronic diseases, like diabetes.  That's where the Diabetes Ten City Challenge (DTCC) comes in.

The DTCC, conducted by the American Pharmacists Association (APhA) Foundation with support from GSK, brought employers, pharmacists, and people with diabetes together to improve the health of patients with diabetes while reigning in skyrocketing healthcare costs.  Thirty employers in 10 US cities established a voluntary health benefit for employees, dependents and retirees with diabetes.

Employers waived co-payments for diabetes medications and supplies to encourage people to manage their diabetes.  Patients worked with local pharmacist "coaches" who helped them track their blood sugar levels and cholesterol, and control their disease through exercise, nutrition and lifestyle changes--and who were compensated for their time. The pharmacists also communicated with the patients' doctors if needed.

Data released yesterday on 573 diabetic patients enrolled in the program for at least 1 year show that average total health care costs were reduced annually by nearly $1100 per patient, or 7.2 percent, compared with projected costs without the DTCC program. Patients also saved an average of $593 per year on their diabetes medications and supplies.  Improvements were seen in blood sugar levels, cholesterol levels, and blood pressure levels, as well as flu vaccination rates, eye exams, and foot exams.

The complete study results appear in the May/June issue of the Journal of the American Pharmacists Association.

Prevention and intervention in action.

(DTCC logo used with permission)

It is pretty well-established that for many diseases, both chronic and infectious, taking your medicines as prescribed (number of pills, frequency, duration of treatment)--what we call medication compliance--is an important way to manage your health.  Especially for chronic diseases, following your doctor's advice can help prevent costlier complications as well.

But this is not only the case in the developed world.  In less-developed countries, it is often difficult for patients to see the value of finishing a prescription, especially if symptoms have disappeared. 

Take drug-resistant tuberculosis, which is a big problem in many poor countries.  The treatment for TB is antibiotics for 6-months, which have side effects like nausea, and patients often stop taking them, which can lead to drug-resistant forms which are costlier to treat.  How to get them to comply?

Researchers at MIT's Innovations in International Health program came up with an ingenious/bizarre monitoring system that combines cheap, paper-based diagnostics with text-messaging technology to reward patients for adhering to the drug regimen.   

The MIT team developed a basic paper-based test that detects metabolites of the TB drug in urine. The metabolite reacts with chemicals in the paper, revealing a numerical code. A patient would take the test daily and text the code to a central database. Those who take the drugs consistently for 30 days would be rewarded with cell-phone minutes.  The pilot program ran in Nicaragua, with a larger trial currently running in Karachi, Pakistan.

I would have LOVED to have been in the brainstorming session for that one.  But there are a few simple lessons that we can use here in the US as we embark on what will surely be radical reform to our healthcare system:

1. Patients, especially those with chronic diseases, need to take their medicines as prescribed to manage their health and prevent complications, which cost more to treat.
2. Patients must see the value of taking their medicines, especially when symptoms are not a daily reminder of their conditions.
3. Patients often need to be encouraged, supported, and rewarded to continue their treatment.

Sometimes the most off-the-wall idea should not be dismissed.

GSK's CEO, Andrew Witty, was interviewed on BBC World Service's Healthcheck program, which aired on Monday, March 30.

The program follows up our pledge to expand access to medicines in the developing world made during a speech Andrew gave at Harvard in February. The interview explored the different aspects of our commitment--access to medicines, sharing intellectual property and patent pooling.

Listen to the interview.