MRII Annual Conference 2018 considers why Ireland is lagging behind in innovative medicines

As the educational and networking body for healthcare industry professionals, the MRII Annual Conference is known for an agenda that is often eclectic and always thought-provoking – and this year’s event did not disappoint.

The venue for the meeting was Killashee House Hotel, and delegates in the packed room were treated to talks on a range of topical issues, spanning healthcare to self-care.

A lively panel discussion kicked off proceedings, as MC and RTE broadcaster Cormac Ó hEadhra stoked debate on the thorny issue of “Innovative medicines and technology are a valuable investment in health – why is the Irish system lagging behind?” Dr Roisin Adams, chief pharmacist at the Acute Hospitals Drugs Management Programme, explained that the HSE must make difficult decisions when it comes to funding medicines, but cautioned against comparing Ireland to other European countries as this is not comparing like with like – for example, in Germany, private health insurance covers the cost of most medicines.

She stated, however, that from a “speed perspective”, some of these decisions do fall behind other jurisdictions.

“We are being asked to make decisions on drugs with far less evidence than before,” she cautioned, adding that submission of the best price from pharmaceutical companies at the earliest stage could also assist in speeding up the decision making process.

CEO of the Irish Healthcare and Pharmaceutical Association, Oliver O’Connor criticised what he saw as the Government’s failure to ensure access to new medicines for Irish patients, explaining that a recent report by the Association had found that Ireland was lagging behind other Western European countries in terms of availability and in many cases Irish patients were accessing medicines 16 months after patients elsewhere in Europe.

He told the audience that he believed this lag had developed in the 10 years since the financial crisis; health spending was “squeezed” and has not increased since then.

Looking at the situation from the pharmacoeconomic perspective was research fellow in Public Health and Primary Care, Dr James O’Mahony. “Cost-ineffective medicines should never be funded but we often do just that here in Ireland,” he said. He suggested if pharmaceutical companies are seeking faster access to their medicines, they should endeavour to show better value.

Patient advocate Dr Derick Mitchell from the Irish Platform for Patient Organisations, Science and Industry (IPPOSI) noted that not everyone will always agree on what is best from a patient perspective, but he emphasised that transparency is a key issue; patients struggle to understand how the decision making process works.

He added that while he supports the assessment process – funding a drug that provides only very small incremental improvements and is not truly innovative should not occur if this reduces access to other key services.

The explosion in technology means this is also something that requires ongoing investment, yet this is also not happening within the Irish health service; Dr O’Mahony said it is “wellaccepted that there is a backlog of investment” when it comes to some of the capital equipment within Irish hospitals.

Fran Hegarty, Chief Healthcare Technology Officer with the Children’s Hospital Group, outlined some of the cutting-edge technology that will be in use at the new National Children’s Hospital, with unprecedented integration of technology and equipment. “This is a project that is very much a good news story, and we are investing heavily into the infrastructure.”

Next up was Ms Julie O’Donnell, CEO of One15, who discussed “redefining the sales call” and how integrating digital can improve the customer experience and ultimately business outcomes. She delivered some home truths, telling delegates that they “need to think hard about the landscape in which we are operating”.

Tech behemoths such as Amazon and Google are entering the healthcare space and this will completely transform the customer experience, she explained. “There are so many different experiences that they can create for customers driven by their data and the partnerships that they have. These are companies that are moving faster than your companies are able to move and they are raising the bar.”

Doctors are extraordinarily tech-savvy; neurologists are top of the list of healthcare for using Instagram, and an Irish haematologist is in the top 20 most influential Twitter users in haematology globally. O’Donnell said recent data showed that doctors are clicking on ads on medical websites more than other European doctors, and healthcare professionals who are engaged across multichannel are 30% more likely to prescribe.  

“The online and offline worlds are colliding – people no longer go online, they are online the whole time thanks to smartphones. That means every time you speak to a customer, digital is involved.”

The pharmaceutical industry must look to the automotive and banking industry and how they have adapted to this new reality, O’Donnell continued; she cited Audi City where customers customise their car to their own needs, or the Apple Genius Bar, which gives customers a chance to use different products and explain what they need.

“These give customers a seamless experience – it’s about really doing customer relationship management so that they get the best experience every time.”

O’Donnell concluded by explaining to attendees that the new reality is “ruthless targeting and a focus on the customer experience”. The data shows that pharmaceutical companies focusing on this are excelling, she said. “It’s not about digital or face-to-face, it’s the right mix for the customer and how digital can enhance the face-toface experience.”

An educational but moving presentation came from Mr Rolande Anderson, a counselling consultant and author. Entitled “Alcohol – the family fall-out”, he outlined stories from his years of experience in dealing with alcohol dependence. “This fallout can be short or long-term, but almost always has devastating consequences. It is usually hidden but it is profoundly damaging to all concerned,” he told attendees.

Anderson outlined how the definition of drinking has changed, having shifted from being labelled an alcoholic or not, the “alcohol continuum” is now how it is viewed. This can range from low-risk drinking, to hazardous, to harmful, to dependent; even low-risk drinkers can have a one-off catastrophic incident because of alcohol that can affect their families in devastating ways.

The language around alcohol dependence was highlighted by Anderson; he said phrases such as “functioning alcoholic” or “addictive personality” are inaccurate and not helpful.

For any person with alcohol dependence issues, their spouse or partner will be impacted severely, said Anderson; they can suffer emotional, physical, and/or mental health problems. These can be compounded by practical issues such as debt and separation or divorce. Children will also suffer hugely; as well as inconsistency and neglect, there can be incidents, accidents, and outright cruelty. “All children are damaged by drug or alcohol abuse in the home – the impact is almost always overwhelmingly negative.”

He criticised the lack of support for partners and family once those suffering from alcohol dependence are in treatment, but noted that group/family therapy, self-help, and cognitive behavioural therapy (CBT) can help significantly, although progress may be slow. “Family members are often in fear – even terror – and they need encouragement, patience, and confidence, not punishment.”

The event concluded with a star turn from John Lonergan, ex-Governor of Mountjoy Prison and best-selling author, who delivered an uplifting presentation on “Nourishing Happiness and Contentment”. He urged the attendees to look on the bright side always – that to be happy, one must want to be happy. Material things provide only a fleeting sense of happiness – the new car or even winning the lottery is not a recipe for true contentment.

Proper diet and exercise, as well as limiting screen time, will also immeasurably help and improve mood and wellbeing, said Lonergan. He concluded by stating that the three raw ingredients of happiness are: something to work for, to dream for and someone to love. He also urged people to let go of former unhappiness: “Don’t spoil today by dwelling on yesterday.”

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