Friday, March 20, 2009

Darwin and the History of Pharma

Darwin and the History of Pharma


March 20, 2009

By Stewart Adkins

Allusions to Darwin can be fun and I suppose corporate archaeologists of
the next geological era will happily sift through the promotional
detritus of yesteryear (Lucites, mugs, pens etc) as the only remaining
fossil evidence of the existence of the pharmaceutical dinosaurs that
are already extinct - AH Robins, Fisons, Syntex, Burroughs Wellcome,
Marion Labs, Pharmacia, Upjohn, to name a few.

However, those fossilized remains will give few if any clues as to the
reasons for the extinction of their originators. For the industry has
not been hit with the pharmaceutical equivalent of a large meteor that
blotted out the sun for millennia; rather there has been a series of
subtle changes in the environment that have been well flagged over the

There are two fundamental problems for the industry to deal with;
firstly, the lead time for new drug discovery through to
commercialization is much longer than the duration of most political or
regulatory regimes, with the corollary that industry has to take a
thoughtful and strategic view as to the long term health needs of
society in order to direct its R&D without concerns that the environment
will shift in the interim.

Secondly, the healthcare needs of society do not revolve around the
consumption of medicines alone; any consideration of how to help solve a
healthcare problem needs to embrace a more holistic approach to
prevention and treatment involving all relevant stakeholders - patients,
physicians, providers of care or medical interventions and payors.

This is clearly an ultra-simplistic view but defining the problem in
such basic terms can be helpful in allowing a view of the wood rather
than just the trees. Extinction may be too harsh a word to apply to
companies who were the subject of hostile takeovers or reluctant
(sometimes willing) mergers since some of these could probably have
survived alone.

However, very few companies seem to have acknowledged and planned for
the fundamental problems identified above; an intense focus on line
extensions, lifestyle diseases and the medicalisation of life's usual
travails at the expense of more basic understanding has left companies
with portfolios struggling to demonstrate value in a society with little
disposable income.

Meanwhile, placing the product at the centre of all sales and marketing
efforts rather than the patient has channelled too many financial
resources in the wrong direction and resulted in corporate
infrastructures that are structurally misaligned with society's needs.
It is not too late to change, for those with vision and the financial
resources to manage through the transition but as in the past, those who
struggle to adapt or don't see the need to adapt may face extinction,
through hostile takeovers or reluctant mergers. Happy Birthday Darwin.

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Disease-Centric Communities Thrive, But Ad Opportunity is Elusive

Disease-Centric Communities Thrive, But Ad Opportunity is Elusive

By Virginia Citrano <> , ClickZ, Mar 20,

Though doctors are now showing a high degree of interest in online
social networking, consumers with illnesses were there well before them
and their fast-growing communities may present an opportunity for the
medical and pharmaceutical industries.

Membership in TuDiabetes <> , a network for
English-speaking diabetes patients, is now nearing 8,000 and growing at
10 percent to 15 percent a month. EsTuDiabetes
<> , its sister site for Spanish speakers, is
growing at an even faster pace and both sites have a global following.

"It definitely came as a very pleasant surprise," says the sites'
founder, Manny Hernandez, of their growth. "Because I am very open about
[my diabetes], I was surprised to hear people say this is the first time
I've had the chance to chat with people about diabetes."

And they are chatting in many places besides the TuDiabetes sites, which
was started in 2007. DailyStrength has separate communities for type 1
and type 2 diabetes, and, last November, the Juvenile Diabetes Research
Foundation launched its community, Juvenation. The sites come on top of
dozens of well-trafficked blogs, like DiabetesMine and portals like
Diabetes Daily and the doctor-focused DiabetesConnect. There are also
community-like sites created by pharmaceutical companies for their
products, like the one for Sanofi-Aventis' slow-release insulin shot
Lantus. The site was ranked highest for satisfaction in a new
ManhattanResearch survey of ePharma consumers.

The corporate sites are, of regulatory necessity, less freewheeling than
their independent counterparts. Pharmaceutical companies are required by
law in the U.S. to report to the U.S. Food and Drug Administration any
problems caused by their drugs and kvetching is pretty much a staple of
user-generated content on any social networking site. But
ManhattanResearch notes that corporate sites can add rich features to
their sites that make them highly attractive to consumers, such as
instructional guides and videos, money-saving coupons and access to
customer-service representatives. (The "ePharma" report looked beyond
diabetes to assess visitation and satisfaction on more than 40 company
sites and more than 50 unbranded sites.)

TuDiabetes is arguably the most tech-savvy of the independent diabetes
communities: Hernandez built it on social networking platform Ning, the
company at which he worked before starting TuDiabetes. His new venture
has just two full-time employees, but relies on a network of member
volunteers to keep the discussions free of spammers and welcome new
members. The volunteers read every new sign-up and send a personal
e-mail to help the newcomer find the discussions most appropriate to
their diagnosis.

The Venezuela-born Hernandez, who is fluent in both English and Spanish,
started his community in the former but quickly realized that there was
as great a demand for information in Spanish-speaking areas of the
world. EsTuDiabetes now has a following not only in Venezuela, but in
Mexico, Spain, Ecuador, Chile, Costa Rica and among Latin Americans in
the U.S.

Despite the seemingly crowded landscape, Hernandez, who was diagnosed
with diabetes in 2002, says his greatest competitors are "ignorance and

"Putting together all the online communities that serve diabetes
patients, we're probably not even getting to 100,000 people," said
Hernandez. "Yet there are 25 million diabetics in the U.S and 250
million worldwide." The World Health Organization expects the number of
diabetics to reach 366 million by 2030.

With statistics like those, it's easy to understand the strong interest
in branded and unbranded drug and disease communities evidenced in the
ManhattanResearch survey. And many of the unbranded sites already accept
pharma and general consumer advertising. But like their counterparts in
the broader social networking space, they are wary of intrusions.

"We don't want people joining just to promote a product," said
Hernandez. "We feel it is important to keep ads established as such and
separate from conversations. Those have to stay between patients because
that is how the site provides the most authenticity."

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Thursday, March 19, 2009

A glimpse into the surgery room online

Source: (Hippocratech)

Who hasn’t watched the latest Grey’s Anatomy as medical residents fight tooth and nail to have a glimpse of cardiovascular surgeon Erica Hahn performing a double valve replacement on the father of medicine, Wiiliam Tapley? So little space in the operating room, so little opportunity for future surgeons to improve their cutting operating skills.

SurgyTec is an initiative develped by plastic surgeon Stevens MD, PhD to solve that. The site’s goal is to improve and share surgery techniques in order to improve one another’s skills. Physicians can now watch videos from ACL reconstruction to performing a midface lift.

So if you need a last minute refresher course on the use of robotic total mesorectal excision for the treatment of rectal cancer, SurgyTec is the place to visit!

Original blog:

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RealSelf: Cosmetic Surgery Community Online (

According to The American Society for Aesthetic Plastic Surgery (ASAPS) Cosmetic Surgery Statistics:

  • Nearly 11.7 million surgical and non-surgical cosmetic procedures performed in the United States in 2007
  • Top five non-surgical cosmetic procedures in 2007: Botox Injection (2,775,176 procedures); hyaluronic acid (1,448,716 procedures); laser hair removal (1,412,657 procedures); microdermabrasion (829,658 procedures); and IPL laser treatment (647,707 procedures)
  • Top five surgical procedures for women: breast augmentation, liposuction, eyelid surgery, abdominoplasty and breast reduction
  • Top five surgical procedures for men: liposuction, eyelid, surgery, rhinoplasty, breast reduction to treat enlarged male breasts, and hair transplantation

With Americans spending just under 13.2 billion on cosmetic procedures last year (ASPS), it was inevitable that a health-community site would sprout up centered around beauty through cosmetic enhancement.

RealSelf was developed by Tom Seery (who used to work at Expedia) in 2006 after his wife complained that it was easier to find reviews on hotels than laser surgery. Backed by investors with impressive backgrounds: Rich Barton (Chairman and Chief Executive Officer of Zillow), Nick Hanauer, and Bill Gossman, the site is making a splash in the cosmetic industry.

RealSelf contains reviews by patients who has undergone cosmetic surgery. What makes the site so addictive are the stories told by patients complete with extremely vivid pictures. Besides patients’ contribution, the site has board-certified cosmetic surgeons answering questions, which further adds to the site’s credibility. This is a great site for those considering an enhancement to their beauty and need information from people who have gone through the surgery.

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Ad Agency Hill Holiday dumps website for "all-blog format"

Ad Agency Hill Holiday dumps website for “all-blog format”

source: Fuel Lines (

An ad agency has dumped its website for a blog. But not just any ad agency, one of the best known agency’s in the country, Hill Holiday, has done it. They now have an “all-blog format.” Could this be a trend, perhaps the wave of the future. I predict that it is.

Complete Story:
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Harvard Economist Blames Twitter for Down Economy

Harvard Economist Blames Twitter for Down Economy

A new study suggests that Twitter is the root cause of the current
economic malaise. Policy experts predict a Twitter moratorium may be
declared for Summer 2009 as part of an effort to stimulate economic
production and reverse GDP declines.

Read more:

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Facebook's New Layout: A Detailed Guide

For all those frustrated with the new facebook layout (and apparently many of you are), here is a great guide provided by a company called The Advanced Guard (  Someone I was following tweeted his frustration with the new layout by comparing it to "moving furniture in a blind person's house".  So appropriate.  Well, this guide does an outstanding job of laying out a map.  Enjoy.

Below is a description from


With the recent update to Facebook Pages, many brands and businesses will be left wondering how they can best take advantage of this upgrade. The Advance Guard has collected some ideas and tips into a white paper that can now be freely downloaded and shared under a Creative Commons license.


  • Optimizing Tabs for maximum effectiveness.
  • Strategies to increase activity on your Wall and Stream .
  • Choosing the right Applications to install.
  • Creating custom landing zones for newcomers.
  • Increasing viral spread of your brand, and things to avoid
  • Recruiting new Fans and engaging with existing ones.


The Advance Guard is a new media consultancy that creates radical marketing programs using disruptive technologies, community platforms and social media. Our clients include American Eagle Outfitters, Verizon FiOS, The Coca Cola Company, HBO, and Warner Brothers.

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Another Reason to be Skeptical of "Analysts"

The Times runs a piece today citing a media analyst at Sanford Bernstein claiming:

...monetizing Twitter “would be difficult at best and likely unsuccessful.” People who sign up for free services tend to resent a company for trying to wring revenue from the business later. Subscription fees are out of the question, they said, and advertising-based revenues don’t seem to have yielded enough cash flow to make a Web 2.0 property viable.

I agree about one thing - building ad platforms like Tweetsense will be difficult. But nothing valuable is ever easy. Adwords was not easy. Overture was not easy. What Facebook is building is not easy. And TweetSense won't be easy.

But that's the point, isn't it? If it was easy, everyone would do it.

To be entirely clear, Twitter has at least three major potential revenue streams.

1. Tweetsense - AdWords and AdSense like platform for Twitter. This has major scale potential.

2. Branded licensing. This is stuff like Stocktwits, where Twitter could promote and perhaps gets licensing fees.

3. SMS/carriers - deals with carriers to split revenue driven by mobile tweeting.

And there are plenty more.

Analysts who write stuff like this are clearly not thinking very hard about the potential of services like Twitter, nor do they understand the appetite for risk the venture capitalists backing such ideas have. Check this quote:

"Whoever buys Twitter, they wrote, “will likely have to operate it at a loss in perpetuity, or until the next cool Web 2.0 social networking concept comes along and Twitter tweets no more.”

Utterly ridiculous on so many fronts it's hard for me to summon the energy to refute it. The idea of the tweet as the query, the idea of brands wanting to have a commercial "response" to searches (and tweets) on Twitter, these are not small ideas. The idea of real time search, conversational and social search, real time "AdWords" - these are not minor new wrinkles. They are here to stay. Twitter is a very promising service directly in the center of these trends, trends the "analysts" at Sanford Bernstein clearly do not grasp.

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Internet is primary means of support for people caring for elderly parents

Internet is primary means of support for people caring for elderly parents

More than 65% of people caring for elderly parents use the Internet as their primary means of support and encouragement, according to a survey from Family caregivers use online forums and message boards to connect with other caregivers. According to the survey, 53% of caregivers provide care for 40 or more hours per week, while 36% get a break of less than 5 hours a week. Yet they manage to squeeze in time online. Most users post on very late at night or early in the morning, says the site.

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Wednesday, March 18, 2009

Chugai Discloses Side Effects of Roche RA Drug: 15 Deaths Reported

TOKYO -- Roche Holding AG's new rheumatoid arthritis treatment might have been a causal factor in the death of 15 out of nearly 5,000 people who took the drug in Japan, with serious side effects such as pneumonia and severe fever detected in over 200 people, Roche's Japanese partner said Wednesday.

The drug, Actemra, is one of Roche's most important new products in development.

A spokesman for Chugai Pharmaceutical Co., which is 60%-owned by Roche, confirmed Japanese media reports on a study into nearly 5,000 users of Actemra. The spokesman said the company "can't deny" that there may have been "a causal relationship" between the drug and the deaths. He said the company will provide more information so that doctors can have a better understanding of possible side effects.

The study was conducted by the Japanese company as part of requirements imposed by Japan's Ministry of Health, Labor and Welfare when the drug was approved.

Roche said that the death rates among patients taking Actemra were similar to those of rheumatoid-arthritis patient populations generally, and also similar to those of patients taking other biological drugs for rheumatoid arthritis. "We don't see a deviation here that gives us reason for concern," a Roche spokeswoman said.

A pharmaceutical analyst for Morgan Stanley said the death rate of roughly 0.3% of Actemra users is similar to the death rate of Enbrel, an "established RA therapy." Morgan Stanley said it continues to forecast peak Actemra sales of 1.65 billion Swiss francs ($1.39 billion) despite the Japanese reports.

Actemra is approved for rheumatoid arthritis in Japan and the European Union but not yet in the U.S., where the Food and Drug Administration has asked the company for a new animal trial of the drug and other information. The biological drug treats rheumatoid arthritis in a new way -- by blocking a protein in the body called IL-6, which plays a role in inflammation.

The Chugai spokesman said his company expects sales of 15.5 billion yen ($157.3 million) for 2009 from the drug, which was first approved in April 2005 in Japan as an agent to treat enlarged lymph nodes and then in April last year to treat rheumatoid arthritis.

Japan's health ministry had requested a study of all Japanese patients who had taken Actemra and Chugai will continue the study until the ministry obtains enough data.

According to the interim results of the study into 4,915 cases, conducted through doctors who prescribed the drug, heavy side effects such as severe fever, pneumonia and phlegmon were found in 221 cases, the Chugai spokesman said.

—Jeanne Whalen contributed to this article
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Cephalon's Provigil may be addictive-US study

Cephalon's Provigil may be addictive-US study


By Julie Steenhuysen

* Addictive signature in Cephalon narcolepsy drug

* Provigil boosts dopamine levels in brain

CHICAGO, March 17 (Reuters) - Provigil, a narcolepsy drug increasingly used by healthy people to boost brain performance, may be addictive in vulnerable people and should be monitored, U.S. drug abuse experts said on Tuesday.

A pilot study on 10 healthy men found that at normal doses, the Cephalon Inc (CEPH.O) drug known generically as modafinil increases levels of the reward chemical dopamine in the same part of the brain that becomes active with other drugs of abuse.

"It has the signature that it could potentially be addictive," said Dr. Nora Volkow, director of the National Institute on Drug Abuse, whose study appears in the Journal of the American Medical Association.

"Studies have shown consistently that all of the drugs of abuse ... have a common effect of increasing dopamine in this area, in the nucleus accumbens," Volkow said in a telephone interview.

"That is believed to be crucial for their reinforcing effect and ultimately their underlying potential for producing addiction."

Cephalon said in a statement the findings are consistent with what is already known about the drug, noting that it is classified as a schedule IV medication by the Drug Enforcement Administration, meaning it has some potential for abuse and dependence.

While officially approved only for excess sleepiness associated with narcolepsy, sleep apnea, and shift work disorder, Provigil is also used for weight loss, attention deficit hyperactivity disorder, fatigue and depression. Last year, it had sales of more than $852 million.

But its increasing use on college campuses to improve cognitive performance led Volkow to look more closely at the drug's potential for addiction and abuse.

"The main problems that we see are not the people who are properly prescribed the medication, but individuals who may be misusing and abusing the medication," Volkow said.


In December, Volkow said recent surveys on college campuses suggest drugs such as Novartis' Ritalin (NOVN.VX), or methylphenidate, and Provigil are being used by students, professors and others as a brain-boosting drug.

Volkow said it had not been clear before the study whether Provigil increases dopamine -- the same chemical reward system in the human brain as other drugs of abuse.

The researchers used positron emission tomography and a well-known drug of addiction to trace the activity of modafinil in 10 healthy men between the ages of 23 and 46.

Volkow said the preliminary findings show modafinil activates the dopamine reward system in the brain. "That potential had been dismissed for modafinil because it was believed it had no significant dopinergic effects. Our findings question that," she said.

"The message for individuals who are taking this medication who want cognitive enhancement is that its use could result in very serious cognitive effects, including addiction."

Volkow said her agency plans to begin monitoring use of modafinil in its regular surveys of potential drugs of abuse.

(Editing by Maggie Fox and Sandra Maler)

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Botox v. Reloxin: Market Share Battle May Revive DTC Spending Late in 2009

Botox v. Reloxin: Market Share Battle May Revive DTC Spending Late in 2009
Source: Pharma Marketing Blog (John Mack)
you thought the DTC advertising sleep aid (Lunesta v. AmbienCR v. Rozerem) advertising war was excessive, wait until Reloxin is approved for marketing by the FDA, which may happen during the second half of this year according to (see "Medicis's Reloxin May Vie With Botox in U.S. to Clear Wrinkles").

“The results of the study [published in the March/April issue of Archives of Facial Plastic Surgery] show that it’s as good as Botox," Ronald Moy, the lead author of the study and a professor in the medical school at the University of California, Los Angeles, in a March 13 telephone interview. "The side effects are the same as Botox."
Click link below to continue:
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Tuesday, March 17, 2009

Tit-for-Tat Tithe on Pharma Marketing. How It Can Work

Tuesday, March 17, 2009

Tit-for-Tat Tithe on Pharma Marketing. How It Can Work.

Source: Pharma Marketing Blog (John Mack)

A few weeks ago, Fabio Gratton, Co-founder nd Chief Innovation Officer at Ignite Health and ePharma Pioneer Club™ member, was a guest on my Pharma Marketing Talk live streaming audio/chat show where he enlightened us about "How To Measure Social Network Communications Success" (see PMT Show #69).

During that interview, Fabio threw out a half-baked idea idea intended to help pharmaceutical companies effectively use social media networks by limiting the regulatory risks in exchange for setting aside 10% of their resources (online ad spend? total marketing? profits?) to promote general health and well being.

For the complete story, click below:

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FDA Widgets: How About One for Adverse Event Reporting?

Tuesday, March 17, 2009

FDA Widgets: How About One for Adverse Event Reporting?

source: Pharma Marketing Blog (John Mack)

Fabio Gratton is at it again! He has started a poll, which asks "To all pharma marketers: A universal FDA Adverse Event widget required by all pharma websites (brand, disease, social) would be effective?"

I assume he is following up on the "Tit-for-Tat Tithe" idea and that the widget he is proposing would allow visitors to pharma websites to easily report adverse events DIRECTLY to the FDA. This would lift the burden from pharmaceutical companies to track, investigate and report the adverse events themselves and free them up to focus on using social media sites for marketing purposes.

Sounds like a good idea. What do you think? Take Fabio's poll here.

Meanwhile, here are a few widgets developed by third parties that push out FDA information on drug safety topics. They are not interactive in the sense that you can enter information into them.

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Monday, March 16, 2009

twtpoll ::To all pharma marketers: A universal FDA Adverse Event widget required by all pharma websites (brand, disease, social) would be effective?

twtpoll ::To all pharma marketers: A universal FDA Adverse Event widget required by all pharma websites (brand, disease, social) would be effective?

Posted using ShareThis

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Pink Tank Launches New Website: KNOWHER.COM

Pink Tank Launches New Website

Marketing to Women Division of GSW Worldwide Introduces

COLUMBUS, Ohio March 10, 2009- Pink Tank, a division of GSW Worldwide,
an inVentiv Health company (NASDAQ: VTIV), recently launched a new web
site at

Pink Tank is a full-service consultancy, specializing in women and
health that helps marketers connect with the female influencers in
healthcare, whether they are healthcare professionals, patients,
caregivers or consumers. The Pink Tank team consists of experienced
marketers with a unique combination of marketing to women experience and
professional healthcare expertise.

The fun and easy-to-use site ( reflects Pink Tank's
specialized offerings and ability to find the affinity point that
resonates with a woman and her healthcare provider, while also providing
information about strategic consulting services that recognize future
trends and emerging brand opportunities for clients who want to reach
women consumers.

"Over the past two years, Pink Tank has generated so much interest we
wanted to make it easier for people to find out what we are about," said
Marcee Nelson, founder and president of Pink Tank. "Previously,
information about Pink Tank was found only through GSW Worldwide's
website so it seemed like the right time for us to create
The site will allow us to expand our reach and give people a chance to
explore in more detail how our unique blend of expertise might help them
with their marketing challenges," says Nelson.

The site explains how Pink Tank's combination of marketing to women
experience and health care expertise makes the group uniquely equipped
to bring a health lens to consumer products or the ability to impact
both sides of the physician/patient conversation in the pharmaceutical
space. There is information about how Pink Tank can help streamline the
strategic process with proprietary insight mining methods and strategy
tools like Conversation Mapping(tm) and Empathology(tm).
also highlights Pink Panels(tm) and Pink Rooms(tm), tailored qualitative
research techniques that help uncover the hardwiring that drives
behavior and can measure an idea's "shareworthiness" among women.

"Pink Tank fills a gap because healthcare is a world of practical
benefits but the way in which women make health decisions is anything
but practical," explains Nelson. "We hope the site reflects various ways
in which our team can help create a lasting, impactful brand experience
for all stakeholders involved in healthcare decision making."

About Pink Tank

Pink Tank is a full service consultancy specializing in women and health
strategy and creative. Pink Tank generates media-neutral big ideas that
come from a unique combination of consumer and professional healthcare
brand experience for a wide variety of products including prescription,
over-the-counter, health & wellness and better-for-you products.

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Sunday, March 15, 2009

Another Lunch with Big Pharma-Novartis Has Its Hands Full

Another Lunch with Big Pharma—Novartis Has Its Hands Full

December 13, 2008

By Barbara Brenner, Executive Director, Breast Cancer Action


Today’s lunch time entertainment was a presentation by Novartis to promote Zometa. The program was called “Metastatic Breast Cancer: Why are my bones important?” The company rep started by telling us that this drug is doing great things for women, but that there are still lots of people who are untreated but who need to be. She expressed the hope that we would obtain useful information for the patients we talk to, or, at least, to remember to call Novartis if we have questions.

The first speaker was Marcia Strassman, an actress (Welcome Back Kotter) who was diagnosed with bone mets at her initial diagnoses. She is now partnered with Novartis (and has a Facebook page) to offer support and information to other people with breast cancer about the importance of following prescribed treatment. In the case of Zometa, that's an infusion every 28 days. Marcia was diagnosed after she found what she called a mound, even though she had been getting regular mammograms and had had one 7 months before her diagnosis. Fortunately for her, she had been involved in a benefit to raise money for cancer research for years, and had access to the best doctors. Unfortunately, a scan revealed bone mets, and we she was placed immediately on Arimidex and Zometa. She said she had an allergic reaction to Arimidex, so was switched to Femara. She was very thankful for the drug, which happens also to be made by Novartis. She wanted us to know that most of her activities have not been affected—she’s living her life, and doing her treatments. In fact, she told the group that she was able to get her Zometa when she traveled.

Turned out when she was asked about getting Zometa on the road that Marcia has a health insurance plan that lets her do things that an HMO or an uninsured person can’t do. Great representative for what happens to people with breast cancer, no?

The next two presenters were both doctors—Adam Brufsky and Hope Rugo. They talked about the importance of bone health, and the powerful effect of Zometa. Neither of them disclosed how much Novartis pays them for their work on behalf of the company. Brufsky wanted us to know that great progress has been made in breast cancer, and that the majority of women diagnosed now will be cured of their disease. He promised that in the next few years we’ll see phenomenal progress. (Where have we heard this before?) And he credited the advocates in the room for raising money for research, and urged us to keep doing that. (I can’t be sure, but I’m betting that most of the women in the room work for organizations that don’t raise money for research.)

Hope Rugo framed her presentation interestingly, pointing out that she would talk about what happens in the real world with Zometa, and noting that clinical trails are, as she put it “a little contrived.” She spoke glowingly of the advantages of Zometa, and stressed at some length how rare osteonecrosis of the jaw is as a side effect.

Then it was question time, and that got interesting. Questions could be posed in writing or verbally. Some questions were about treatment issues. I asked about the fact that the company, which makes all these drugs that are addressing cancer like Zometa and Femara (an aromatase inhibitor), also makes the herbicide atrazine, which stimulates aromatase. There was a question about Evista (raloxifene) for breast cancer, which Hope Rugo handled quite well, pointing out that the drug is not a breast cancer drug, but that she prefers it for “prevention.”

Roberta Gelb, an activist who works with several organizations, pointed out to Dr. Brufsky that, despite his urging, none of the advocates in the room would tell the patients they work with to live their lives and leave their breast cancer to their oncologists. After a defensive response from the doctor, the session ended.

The activists with whom I spoke after this lunch were deeply offended by the presentation. They felt patronized and angry. It’s clear that Novartis did not know who was in the room—very well informed, passionate, and smart advocates and activists who need and demand real information, not pablum sugar-coated by a drug company.

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