1. ASMI congratulates Diamond Awards winners –Celebrating marketing and sales excellence in the non-prescription medicines industry
   23 October, 2017 –The Australian Self Medication Industry (ASMI) recognised excellence in sales and marketing at the prestigious Diamond Awards, held on the final afternoon of the World Self Medication Industry (WSMI) General Assembly in Sydney last week.
   This year, the Marketing Awards featured a new category for Health Literacy, won by GSK for their Panadol + Voltaren Regime campaign.
   The judges felt that this very patient-centric campaign was outstanding for its inclusion of health literacy elements across all touchpoints (consumer & HCP). In the category for Best New Product Launch, Ego Pharmaceuticals’ launch for Sunsense ‘Sensitive Invisible’ won with a campaign that was described by ASMI Marketing and Business Development Director Filomena Maiese as a “great example of local player being agile in responding to changing consumer needs.” The campaign showed a brand responding to critical community needs around sun protection by addressing major inhibitors to daily usage. The campaign tapped into local R&D to address two major barriers to using sunscreen on the face daily – blocked pores and the sunscreen visibility. GSK’s Panadol + Voltaren Regime hit gold again in the category for Best Small Budget Campaign. The quality and scope of all nominees was particularly pleasing for the industry, and the category featured a whopping eight nominees – which was perhaps either a reflection of shrinking budgets or greater efforts to innovate in this category.

   Care Pharmaceuticals won the Best Large Budget Campaignwith the Hydralyte multi-usage occasions campaign.
   “This is a great example of a market leader repositioning itself to grow the market and brand after being previously entrenched in acute usage around rehydration from illness,” Ms Maiese said.

   This year, the category for Best HCP Campaign saw nominees cover a diverse range of healthcare professionals, going well beyond pharmacists and pharmacy assistants. Ego Pharmaceuticals won for its QV Skin Tears in Aged Care Facilities campaign, which demonstrated both clinical and economic benefits of using QV in aged care facilities. This campaign helped develop a completely new incremental channel for QV.

   The Sales Awards recognised excellence among both ASMI’s larger and smaller member with separate prize categories based on pharmacy sales more than and less than $100 million.
   The iLearning Group was again a valuable partner for these awards.
   As an innovative e-learning company specialising in community Pharmacy training and education, their database provided the means to survey 350 pharmacists and 500 pharmacy assistants as part of the judging process.
   The respondents were asked to rate ASMI member companies on six key attributes, including “quality use of medicine”. GSK won the category for pharmacy sales over $100 million, followed by Bayer and Johnson & Johnson Pacific. In the category for sales less than $100 million, Ego came out on top, followed by Apotex and Aspen.

   ASMI congratulates all Award winners and nominees for advancing marketing and sales excellence in the industry. Thanks to Diamond Awards sponsor IRi and Sales Awards partner iLearning Group, and also to David Morgan for his keynote address, Is Australia ready for Next Practice Marketing?

 

2. World health care body reports billions can be saved with more non-prescriptions medicines
   October 20, 2017 – The World Self Medication Industry (WSMI) has used its General Assembly in Sydney this week to launch a new report that puts a dollar value on the potential savings available to nations around the world if some prescription medicines suitable for use in self care were made available over-thecounter (OTC). The report, conducted by Precision Health Economics, demonstrates just some of the impacts that self care is producing, or has the potential to produce around the world. The report quotes figures for Australia that show that a saving of over A$1 billion could be made to the national economy if just a few selected prescription medicines were reclassified to non-prescription status.
   The report reviews existing evidence to support the use of self-medication, focussing on improved patient access to treatments, and the cost-related impacts of self care in terms of healthcare resource use, medication costs and employee productivity. Specific therapy areas were targeted to best demonstrate the potential savings to be had by giving consumers better access to medicines to treat common health conditions or symptoms.

   These conditions included:
   * allergic rhinitis and chronic urticarial
   * heartburn / non-ulcer dyspepsia
   * symptom management of common cold
   * cardiovascular disease

   The first clear finding from the published evidence reviewed in the report is that when a class of medicines becomes available without a prescription, there is a significant reduction in the number of doctor visits, as a large proportion of patients are seeking medical care for conditions that are suitable for self care.
   This claim was supported by Dr Eric P. Brass, Professor of Medicine at the University of California, who also presented at the WSMI General Assembly.

   Dr Brass used the example of Proton Pump Inhibitor (PPI) medicines in the USA to demonstrate the potential benefit of non-prescription medicine availability.
   “Before the availability of certain non-prescription drugs for gastroesophageal reflux disease (heartburn), physician visits were increasing,” Dr Brass said.

   “After the introduction of non-prescription PPIs, the physician visits for GERD were halted and there was a stable visit rate.

   “No evidence was found for increased visits or worsened outcomes for gastrointestinal conditions which might be masked by PPI treatment.”

   The report notes that commonly used non-prescription medicines that have been on the market for many years or even decades have not been examined for their economic value, and more evidence is clearly needed to support the value of self care.
   However, this review goes some way to demonstrate that improving access to medicines that people can use to manage their own health can deliver significant economic benefits to healthcare systems worldwide.

   

   Click image for clearer view
   The full report is available for to read here:
   The value of self-medication: summary of existing evidence – Noone, J. & Blanchette, C.M., Precision Health Economics.

3. WSMI GA expert panel: this is how you respond to key concerns about switch
   October 20, 2017 – 

An international panel of experts on prescription-to-OTC switch have offered some suggestions on how industry can respond to key concerns about down-scheduling.

The panel discussion took place on the final day of the World Self Medication Industry General Assembly in Sydney, following the session Optimising Self Care through Switch.

“Some of the downsides of switch aren’t as bad as people might think they are,” said Scott Koslow, Professor of Marketing at Macquarie University and acclaimed researcher and commentator on how consumers approach health decisions.

“One of the things that people are afraid of is that people would rush into pharmacy and try to get these [down-scheduled] medicines and use them inappropriately. I don’t see evidence of that.

“There are always problem consumers who won’t listen, won’t follow directions, or they want to misuse a product. Are these folks going to rush into pharmacy to use S3 medicines? I don’t think so – they’re actually very happy with the doctor-shopping they’re doing right now.

“The people who are well-educated consumers and turned on to self care, these are the folks who want to avoid doctor visits. But even when we talk about them avoiding physician visits, it’s not the same as eliminating physician visits. More typically, these people are typically visiting a doctor seven times a year – that’s a lot – and a switch may reduce their physician visits to six times per year. So we need to make the point that it’s not like health issues are going to fall through the cracks because a consumer won’t be serviced by a medical professional when more medicines are switched.”

Earlier, in her presentation Australian pharmacy perspectives on demand and readiness for increased non-prescription availability of medicines, Griffith University researcher Denise Hope raised the point that the biggest barrier to down-scheduling came from other (than pharmacists) HCPs. This raised questions about how the switch of sildenafil in New Zealand had affected the doctor-pharmacist relationship.

“You have to win locally,” said Alison van Wyk, Head of Professional services for Green Cross Health. “People talk about ‘fragmentation’ of health care, but you know health care is working when patients only have to tell their story once. For this, you need to establish good communication lines between doctors and pharmacists that focuses on health outcomes – even if the different groups might be competing for funding and so on.”

The panel was also asked how to meet the challenges of “modern” switches – the switch of medicines for chronic or more complex conditions that may require consumers to follow quite complex regimes. How do we get these switches to be more successful, both from a regulatory and commercial perspective?

“One thing we learned several year ago is that when consumers understand the reasons why they’re being given a directive on the label, then they’re more likely to respond properly to it,” said Dr Edwin Hemwall, an independent consultant in non-prescription drug development who served as co-chair of the WSMI Switch Working Group.

“In the USA, drug labels are basically a directive – do this, do not do that. If you tell consumers the reason why they should or should not do something, then there’s a lot more willingness to understand and heed the directive.

“We’ve seen this for a lot of different types of interactions, which ultimately are best written beyond the label itself, like directing them to a website and taking them through a series of steps. If you explain to the consumer the reason behind the instruction and how it affects them directly, then you have a much higher rate of compliance.”

Dr Hemwall used the example of statins in the USA, where switch attempts were not successful.

“All labels for statins in the USA have the warning, ‘Do not take while pregnant’. Adding, ‘because it could harm your unborn child’ would increase compliance dramatically.”

 

4. New Australian research features in WSMI GA call to recognise economic value of self care, switch
   October 19, 2017 – The world-first launch of Australian research will feature front and centre at the World Self Medication Industry (WSMI) General Assembly in Sydney today, where global healthcare experts will call for a greater emphasis to be placed on the economic value of self care. An international line-up of speakers will argue that governments are underestimating the contribution the non-prescription medicines sector makes to better health outcomes, the economic sustainability of health systems and more efficient utilization of healthcare resources. A world-first presentation of new Australian research from Macquarie University will demonstrate why Australia requires a health-economic dimension to determine what medicines consumers can access and how they can access them. Macquarie University Centre for the Health Economy researcher Dr Bonny Parkinson will be joined by several international leaders in healthcare in arguing the economic case for processes that will expedite the evolution of medicines from prescription-only access to over-the-counter access.

   Speakers include Josh Noone from Precision Health Economics and Dr Eric P. Brass. Dr Parkinson’s research demonstrates that an economic evaluation approach could be applied to enhance the decision-making process on how consumers access medicines.

   “Economic evaluations consider the impact on healthcare resource use and costs, in addition to the impact on health outcomes,” Dr Parkinson says.

   “Down-scheduling of medicines can improve patient health outcomes by reducing barriers to treatment, reducing the time to symptom relief, and improving treatment rates and adherence.
   Consequently, the onset of related diseases may be prevented, or disease progression may be delayed or reduced.”

   Dr Parker also points out how greater access to medicines can enable valuable healthcare resources to be used by the patients who need them most.

   “Allowing a medicine to be available over-the-counter is likely to reduce GP attendances just to obtain prescriptions, but improved health outcomes will also lead to less demand for other forms of healthcare, such as diagnostic tests and hospitalisations.”

   While consumers value the convenience of non-prescription medicines, the potential benefits extend to improving consumer health and increasing the efficiency of healthcare delivery,” says Dr Eric Brass, Professor Emeritus of Medicine at the University of California.

   Dr Brass’ presentation will focus on the success of the ‘switch’ of proton pump inhibitors (PPIs) from prescription-only to over-the-counter access in the USA.
   In the decade prior to the introduction of the first non-prescription PPIs in 2003, there was a steady increase in physician visits for Gastroesophageal Reflux Disease (GERD), but this trend in physician visits abruptly plateaued from 2004-2012.

   It is estimated that if the pre-2004 trend had continued, there would have been an additional 5.2 million primary care visits for GERD in 2012.

   “Doctor time is money,” says Josh Noone from Precision Health Economics (USA).

   Mr Noone will argue that another important key component to the health economic contribution of non-prescription medicines around the world is the argue that the greater self-management of health conditions enabled by increased access to medicines delivers productivity gains for doctors, which results in time that can be reallocated to the management of more severe cases where it is needed.

   The final session of the WSMI General Assembly focuses on switch and features new research from Griffith University and presentations featuring and switch experts Dr Edwin Hemwall and Dr Natalie Gauld.

   The Griffith University research, led by Denise Hope, examines which prescription medicines consumers currently expect to access over-the-counter, the medicines pharmacists recommend for prescription-to-OTC switch, and pharmacy readiness for such switches.

   Key findings include:
   * More than 70% of pharmacy staff are asked for non-prescription access to prescription medicines at least weekly.
   * Most commonly requested prescription meds over-the-counter are: antibiotics (24%), analgesics (19%) and contraceptives (11%).
   * Nearly 90% pharmacists agreed that opposition from other health professional bodies is a major barrier to change.
   * Medicines proposed by the pharmacy profession for reclassification align with those available as non-prescription overseas.
   * The most frequently requested prescription medicines often aligned with those considered potential targets for reclassification.
   * Pharmacists agreed on the need to identify and campaign for further potential S3 candidates e.g. more potent or larger quantities of topical corticosteroids.

 

5. Two steps forward, one step back– ASMI issues regulators and industry a challenge to change
   18 October 2017-

Speaking at the opening of the World Self Medication Industry (WSMI) General Assembly in Sydney today, Australian Self Medication Industry (ASMI) CEO Deon Schoombie has challenged both regulators and industry on the need to change.

The WSMI General Assembly has attracted more than 300 delegates from 26 nations, and will include a Regulators’ Forum with representatives from 18 nations.

“This conference is about evidence,” ASMI CEO Deon Schoombie said. “What’s the evidence to support change? We need evidence that supports the value of self care – and the main target is policy-makers.”

Schoombie noted the regulatory reforms that Australia has experienced in the last five to seven years have been “unprecedented in both breadth and depth”, with virtually no aspect of the regulation of medicines and medical devices left untouched.

Schoombie said there were very encouraging developments in relation to prescription to over-the-counter switch, with is interest in ASMI’s push for the development of an Australian switch agenda through a multi-stakeholder collaboration.

“There also appears to be an appetite to allow more Schedule 3 medicines to be advertised. The existing restrictions on the advertising of S3 medicines are counterproductive. Industry needs to be able to communicate directly with consumers to create awareness of S3 medicines.”

However, Schoombie said that in a world moving forwards, Australia sometimes appeared to be going backwards.

“While the global industry is united around the common goal of increasing access to medicines, Australia has seen developments in the opposite direction – greater restriction on the level of access to some medicines.”

Schoombie said that response to these developments and threats should be guided by the available evidence, regulatory decisions based on a “balanced assessment of risk as well as benefit”, and the adoption of the decision tree model (published by Brass, Loffsted and Renn) in regulatory guidelines.

“While progress has been made to restore the appropriate risk/benefit balance, we still experience a tendency towards over-emphasis on risk and risk-aversion management,” Schoombie said.

“These developments raise the question about whether industry could be more vigilant to detect the early signals of such developments, and be more responsive by offering solutions to manage public health and safety concerns in a more proactive fashion.”

The World Self Medication Industry General Assembly continues Thursday October 19, and will include the Regulators’ Forum and the ASMIDiamond Awards for marketing and sales excellence.